Psychotropic medication discussion thread

Matthew White4 said:Look, you can always check the fine print on the pharmacy printout, but honestly, everyone reacts to meds differently. Don't let the anxiety get to you about starting them—they were prescribed for a reason, so just take it one step at a time...

I've read them, sure, but isn't the fear of weight gain just as real?😢

hiddenwalker30 As follows:
I read it. Honestly, I’m just worried about the weight gain. 😢

I haven't experienced any weight gain from the Zyprexa. I have a fast metabolism naturally, so it's not easy for me to put on pounds. The only noticeable change is that I sleep longer.

hiddenwalker30 said:I've read them, sure, but isn't the fear of weight gain just as real?😢

If I were in your shoes, I would certainly explore other antipsychotics before settling on Zyprexa, though obviously, that should only happen after a serious discussion with your doctor.
She really does cause significant weight gain. It doesn't happen to everyone, but for the vast majority? It’s a very real issue.

Jason Vaughn482 said:It is quite a curious predicament when one finds that Valium and Cerson offer absolutely zero relief, especially considering this was my very first encounter with them; I attempted them for the first time and felt nothing at all—they fail to induce even a hint of sleep. Subsequently, I turned to Sanval; while I previously managed with 5 mg, I have now increased the dose to 10 mg, which allows me to drift off and remain asleep for a considerable duration, yet the experience is utterly ghastly because I find myself waking up in the middle of the night to eat without any conscious recollection of doing so. It is as if I am living a double life in my sleep, and I am desperate to break free from this cycle. Now, I am contemplating whether an Antipsychotic might provide the stability I need, perhaps allowing me to transition away from Xanax toward something else? I recall using it for sleep once, back before I had started any other regimen, where taking just one in the evening sufficed perfectly... at that time, anxiety wasn't an issue, merely a mild bout of insomnia. Oh, and I nearly forgot to mention Dormicum, which is a substance I have absolutely no desire to ever experiment with.

Are you saying you don't want to try Zoloft? If nothing else is working, maybe try starting with half a dose.

fadedbear92 said:Here is a list of medications used to treat insomnia

Hypnotics and Sedatives

flurazepam – Valium
midazolam – Dalmane
nitrazepam – Cerson

Benzodiazepine-related drugs
zolpidem – Sanval

Other hypnotics and sedatives
valerian (approved) – Persen

Anxiolytics

Benzodiazepine derivatives
alprazolam – Helex, Xanax, Xanax SR
bromazepam – Lekotam, Lexaurin, Lexillium
diazepam – Apaurin, Diazepam, Diazepam Desitin, Normabel, Valium
lorazepam – Lorsilan
medazepam – Ansilan
oxazepam – Oxazepam, Praxiten antipsychotic

Antipsychotics

Antiepileptics

http://www.psychiatry.com/MATURANT...ihofarmaci.pdf

Regarding Rivotril, medazepam (Ativan) isn't available anymore; I'm not entirely sure why they discontinued it. I personally have never had the need to take it, though it might have been an effective option for managing anxiety once upon a time.🙂

restlesstrucker15 said:Regarding Rivotril, medazepam (Ativan) isn't available anymore; I'm not entirely sure why they discontinued it. I personally have never had the need to take it, though it might have been an effective option for managing anxiety once upon a time.🙂

I've never even heard of that one before.

Anthony Lopez8 said:If I were in your shoes, I would certainly explore other antipsychotics before settling on Zyprexa, though obviously, that should only happen after a serious discussion with your doctor.
She really does cause significant weight gain. It doesn't happen to everyone, but for the vast majority? It’s a very real issue.

I've been taking Vistaril up until now, and then suddenly my doctor switched me over to Oleanz.

hiddenwalker30 said:I've been taking Vistaril up until now, and then suddenly my doctor switched me over to Oleanz.

If that’s the case, there really isn't any reason to worry.

Both Vistaril and Oleanz contain the exact same active ingredient—olanzapine. If you haven't struggled with weight gain up until this point, why would you suddenly start now?😁

fadedbear92 said:I've never even heard of that one before.

Well, I see it listed on that benzodiazepine chart you put together, though it seems to have been removed now.
The same goes for Anafranil; it was quite effective for many people, but it appears they've stopped manufacturing it.

Now, I have a question, purely out of curiosity: does Rivotril work quickly enough to instantly halt a panic attack, similar to how Xanax acts (though I thank God I am no longer taking that), or is its effect more akin to Valium, primarily working to eliminate general anxiety? I am referring to use on an as-needed basis.

Fadedbear92, how have you been sleeping?

Sorry if I’m intruding...

I was wondering if my primary care physician has the authority to prescribe something to help without a referral from a specialist—like a psychiatrist. I want to avoid getting a psychiatrist involved at all costs because I fall into a pretty delicate and rare category of patients that most psychiatrists here just don't get. They aren't properly trained, and most of their opinions seem stuck in outdated textbooks that the rest of the world moved past forty years ago...

Anyway, I've been hit by an incredibly heavy depressive episode over the last few days and I feel terrible. My head is foggy, and it feels like something is physically crushing me. I don't know what to do... I'm even thinking about ending it all if this doesn't let up.

I have no one to talk to about this except my doctor, since he knows my whole history, even though he doesn't know about this current state... Is there any point in asking him for medication?

Emily James4 said:Sorry if I’m intruding...

I was wondering if my primary care physician has the authority to prescribe something to help without a referral from a specialist—like a psychiatrist. I want to avoid getting a psychiatrist involved at all costs because I fall into a pretty delicate and rare category of patients that most psychiatrists here just don't get. They aren't properly trained, and most of their opinions seem stuck in outdated textbooks that the rest of the world moved past forty years ago...

Anyway, I've been hit by an incredibly heavy depressive episode over the last few days and I feel terrible. My head is foggy, and it feels like something is physically crushing me. I don't know what to do... I'm even thinking about ending it all if this doesn't let up.

I have no one to talk to about this except my doctor, since he knows my whole history, even though he doesn't know about this current state... Is there any point in asking him for medication?

No responsible, conscientious doctor is going to start handing out psychotropic meds on their own whim—they'll refer you to a psychiatrist instead.
What kind of patient category are you talking about?

Emily James4 said:Sorry if I’m intruding...

I was wondering if my primary care physician has the authority to prescribe something to help without a referral from a specialist—like a psychiatrist. I want to avoid getting a psychiatrist involved at all costs because I fall into a pretty delicate and rare category of patients that most psychiatrists here just don't get. They aren't properly trained, and most of their opinions seem stuck in outdated textbooks that the rest of the world moved past forty years ago...

Anyway, I've been hit by an incredibly heavy depressive episode over the last few days and I feel terrible. My head is foggy, and it feels like something is physically crushing me. I don't know what to do... I'm even thinking about ending it all if this doesn't let up.

I have no one to talk to about this except my doctor, since he knows my whole history, even though he doesn't know about this current state... Is there any point in asking him for medication?

A PCP can prescribe an antidepressant for milder depression, but for anything more serious, you'll need a specialist to handle it.

Eric Gray2 said:No responsible, conscientious doctor is going to start handing out psychotropic meds on their own whim—they'll refer you to a psychiatrist instead.
What kind of patient category are you talking about?

It’s complicated. Going through gender transition has absolutely drained me, and then my surroundings just finished the job. Old friends walked away, and I can't find new ones because they seem terrified once I tell them the truth. It feels like every door is slammed in my face. I just sit at home, and this loneliness is eating me alive... it's given depression massive wings. Nothing brings me joy anymore, and honestly, I can't even find the strength to have a good cry. My self-esteem is gone. There's just this vacuum tightening inside me... I don't see any way out other than ending it all.

A psychiatrist wouldn't help because everyone has these prejudices against people like me. They don't want to bother reading modern literature; they basically understand nothing. Talking to them usually turns into a series of provocations, like they're trying to "test my pulse" or something. I don't expect them to immediately hand over something to boost my serotonin or whatever else I'm lacking; they just drag these conversations out forever, playing philosopher... while I'm actually suffering.

The reason I hate them most is that during my last breakdown a year and a half ago, they locked me up in a state facility. It was horrific. The staff wouldn't even let me call home to have my usual meds brought to me. They threatened to knock me out with some injection if I caused "trouble." It was nightmare fuel. That's why I don't trust anyone anymore.

I'd honestly rather handle this with my primary doctor without any interference, since I can't get actual support anyway... everyone looks at me like I'm some kind of alien. Everything is just getting worse.

fadedbear92 said:A PCP can prescribe an antidepressant for milder depression, but for anything more serious, you'll need a specialist to handle it.

Look, for immediate first aid, you should absolutely reach out to your family doctor; they can provide something to help calm you down so things feel a bit more manageable, though I realize that isn't a permanent fix. While a GP can certainly prescribe antidepressants, it is generally wiser to have a psychiatrist evaluate your specific situation to determine which medication is most appropriate. There are many excellent psychiatrists out there—younger professionals who are quite empathetic—and you will likely benefit from some talk therapy as well.

In short, start with your primary care physician for initial relief and ask for a referral. I actually know of a wonderful psychiatrist; although finding the right fit is deeply personal, her reputation precedes her. My colleague’s mother is a highly regarded specialist, and she spent three days carefully vetting doctors just to find someone she felt would truly suit my temperament, as she is notoriously picky about her patients. She accepts both insurance and private patients. If you would like her contact information, please send me a direct message.

In that specific situation, I’d really suggest reaching out to Prof. Nataša Jokić Begić—if I remember correctly, transgender health and identity is one of her main areas of expertise, so she’s definitely someone you can consider a specialist in that field.

Eric Gray2 said:In that specific situation, I’d really suggest reaching out to Prof. Nataša Jokić Begić—if I remember correctly, transgender health and identity is one of her main areas of expertise, so she’s definitely someone you can consider a specialist in that field.

I wouldn't. I had a bad experience with her. The real issue is that after everything, I just can't function normally anymore. I go days without talking to anyone because I can't seem to meet anyone. It's this massive wall. If I could just break free from this loneliness, maybe there'd be a foundation to fix things... but instead, all I have are meds to stop me from completely snapping while the same movie plays on loop in my head a billion times.

I don't know what to do, but I probably won't do anything. I can't just walk up to some therapist and say, "Look, doc, loneliness and depression teamed up to destroy me, so please just give me some pills before I kill myself from the misery." I'll probably just end up behind locked doors again if I get too honest, and I don't want that. I can't afford private specialists either, so I'm stuck. It would be nice if it all just stopped, even if it cost me everything...

It sounds like you’re going through a really rough patch right now. Honestly, I think it would be a smart move to go see your primary care doctor first—they can get the ball rolling and refer you to a psychiatrist if needed. And just so you know, not all psychiatrists are out to lock you away or pump you full of meds until you're basically a zombie.

Emily James4 said:I wouldn't. I had a bad experience with her. The real issue is that after everything, I just can't function normally anymore. I go days without talking to anyone because I can't seem to meet anyone. It's this massive wall. If I could just break free from this loneliness, maybe there'd be a foundation to fix things... but instead, all I have are meds to stop me from completely snapping while the same movie plays on loop in my head a billion times.

I don't know what to do, but I probably won't do anything. I can't just walk up to some therapist and say, "Look, doc, loneliness and depression teamed up to destroy me, so please just give me some pills before I kill myself from the misery." I'll probably just end up behind locked doors again if I get too honest, and I don't want that. I can't afford private specialists either, so I'm stuck. It would be nice if it all just stopped, even if it cost me everything...

Even Professor Iva Žegura at the local psychiatric hospital specializes in transgender issues, so you could reach out to her.
Otherwise, I agree with Rosey; I believe you should seek professional help, perhaps starting with your primary care physician.
Good luck.🙂

@Emily James4
You mentioned in one of your posts that nobody’s going to hand you meds right away—that they'll just drag things out with endless talks. Honestly, that’s not how it works. You usually get your prescription right after that first consultation. From there, you can technically stop showing up for follow-ups if you want, though personally, I wouldn't suggest that (but hey, it's your call).
That said, I really feel like psychotherapy would do more for you than just jumping straight into medication.

Everyone seems to be talking about psychotherapy lately. But honestly, nobody ever mentions how you actually go about finding someone or getting started? All I know for sure is that it's incredibly expensive.