u/Weird_Fox_3395

Article from psychiaty online https://psychiatryonline.org/doi/full/10.1176/appi.pn.2022.11.11.13

>>agreed further work with people with treatment-resistant depression is needed, he noted many participants in his clinical studies had taken previous antidepressants, so Auvelity could be a second-line option.

Given its purported effects on the NMDA receptor, Iosifescu thinks one intriguing option for Auvelity is as a take-home medication for people who received ketamine treatment. “In theory, someone who benefits from ketamine would also benefit from this tablet,” he said. “A patient could take it regularly or maybe just as a rescue medication if symptoms relapse,” he said. That is just one of several clinical possibilities that should be tested, he said. Iosifescu also noted that his group is testing Auvelity as a treatment for agitation in adults with Alzheimer’s.

NCBI paper on https://pmc.ncbi.nlm.nih.gov/articles/PMC10591164/

In case any hasn’t been tracking this. I don’t understand all the science, and if you have a better sources, please share.

I’ve maintained 200mg for 5 years. This year, I’m not getting the mood lift. Late Spring, (usually a good time of year), but I’m slipping. For background, I lived with BPll trd for 23+/- years. Ketamine has been miraculous, and I don’t want to fuck it up.

Reading another discussion here about chronic pain treatment, I finally got how ketamine works in the pain protocol. Apparently a high enough dose, delivered rather quickly over a few hours extinguishes pain signal excitation.

So this has me thinking about a dose increase. Not dramatically, just like to 250mg. One wrinkle is I don’t appreciate the ‘k-hole’ experience, and I split my troche and space over 45~.

Perhaps 125mg at once isn’t too much to push me into an uncomfortable place.

I understand some people here need and tolerate higher dose, and 200mg is relatively low. My reasoning is to resist tolerance and take less since this is going to be lifelong. I’m also 66, and how much longer my health will allow me to take it is a concern. (I have other health complication.) That’s perhaps my baked in anxiety. (No health markers have declined in 5 years.)

Regardless of discussion here, this is something to discuss with my provider. He has on occasion offered to raise my dose. Anyways, he’s great.

Our check-ins are always everything is fine. But maybe right now it’s not? I’m very hesitant to bring this up because I personally don’t want it to be true. And I have been fine until January or so.

Any thoughts or experience to share would be much appreciated. Maybe I should learn how to be comfortable with 200mg ‘all at once’?

Thanks so much for reading <3

Edit: Answered!

[original] Hey, overlapping editions of Bolaño’s work confuse me, so here’s a question.

There’s the *Collected Stories* from Vintage; and the *Posthumous Stories* from Picador.

However, I have all the (afaik) separate collections, including *Cowboy Graves*, *The Secret of Evil*, *The Spirit of Science Fiction* as well as the well known New Directions releases.

Given I have all the separate volumes, does either *Posthumous* or the *Collected* add any additional writing??? Also, I read somewhere that *Posthumous Stories* is a reedition of *The Secret of Evil*???

Help me those in the know! FWIW I read in English translation.

Hi, and ofc this is a question for my psych, but I wanted to run it by the sub to help me think.

In January, after 20~ years on and off ADs (mostly on), I successfully tapered from trintellix over a year plus. My depression (I thought) was in remission due to ketamine treatment.

Usually I have an energy boost (sub threshold) in Spring. I really look forward to it. (I also have SAD fwiw.)

This Spring has been pretty bad. Chronic pain flairs, incredibly low energy, inability to concentrate, adhd meds not working.

This week it dawned on me this might be exacerbated by no AD. I felt very proud to be off the ball and chain that triggered my cyclothymia to BPll.

I‘m not sure what response I hope for by posting. My psyche had me hold my stash of ADs, so I have them on hand. I just feel teary and disappointed in myself.

When I see my psychs, I usually downplay my symptoms. (people pleaser? Don’t like to bitch?)

I just saw my ketamine provider and said everything was honky dory. I assumed my low mood was something I could walk off lmao.

*I’ll reach out to my psych before any change.*

FWIW my psych meds are 200mg lamotrigine and ketamine once a week. 10-15mg adderall, plus sleep meds.

I could go up on ketamine but prefer not to atm. This dose has been working for a few years now.

Any of you out there who tolerate ADs go off successfully? Any of you relapse?

Thanks for reading.

Edit: thank you kindly for the replis. The line up is *Ice Rink*, *Last Evenings*, and *The Spirt of Sci-fi* I appreciate your guidance :)

Hey, I completed a sort of a Bolaño arc. In reading order:

*By Night in Chile*
*2666*
(*TSD*)

*Amulet*
*Nazi Lit in the Americas*
*Distant Star*
*The Third Reich*

All related in theme and all except *TSD*. Took a break, and now wondering where next to dive in. I have every title on my shelf, so can get down to business hahaha. (Bolaño is a hell of a drug.)

These posts are generally annoying, and I understand why. They invite a shout of *just pick up anything!* I’m hoping for a nudge because I ‘completed’ a story arc.

Tell me what you have read or want to read if you don’t mind.

[edited to say, I am wrong about *TSD*, especially because Auxillo LaCouture.]

Edit: this question is about indirect sunlight. I can’t edit the title, sorry!

Hey ya’ll. I have sun sensitivity from lamotrigine. I’ve been outside more that the weather is nice. I have a covered deck, so I’m not in direct sun at all. (I’m a pale white person fwiw.)

Sometimes I feel that flushed sunburnt feeling if you know what I mean. My question is prolonged indirect light effect me??

This just occurred to me today. As I sit here feeling flushed :/

Anyone else have a strong reaction to sunlight? Goof for vampires but I don’t like vampires.

BTW: Lamictal can effect the irises of your eyes! So don’t forget your sunglasses. Thinking about this, I should wear my sunglasses now :/

Hey, folks who’ve adjusted their lamotrigine dose past 200mg, did you feel any benefits? Also, if you did increase, how much, and how long until you noticed it kick in? Did you decide to decrease it at another point?

Feb-May are my most challenging months, and thought increasing my dose next winter proactively to deal with a possible episode in Feb-April.

Maybe Lamotrigine doesn’t work this way??

[This is something I’ll talk to him about for sure, but I just want to think about before i see him]

Background:

BPll/cyclothymia plus SAD.

Feb-mid May, I was doing poorly, but I thought maybe I wasn’t trying enough. Finally had to admit it was an episode. Depressed mood, low energy but also mixed.

I saw my psych last week and (like a dolt) said everything is fine, same old same old. This is my habit. I love my pysch; he met me at my nadir. So it’s not like he wouldn’t have listened. (I fucking hate bothering or complaining to people with my moods.) Plus we haven’t made med changes in years. (And I’m afraid of med changes!)

Thanks for reading. If the idea of prophylactic lamotrigine is cracked, just tell me!

Hi, BPll/cyclothymia plus. For at least five years I’ve been stable on 200mg lamotrigine. Lifelong insomniac, decently controlled. I consider my decades long depression in 80~ percent remission.

In the Spring, I usually have a sub threshold hypo. I’m functional during this time. I flag in late winter. Like SAD.

Might this be a depressive/mixed episode? Incredibly low energy with lots of anxiety. My adhd meds don’t seem to be working either.

I usually associate an episode with an upswing, so I’m confused. No new stressor.

I’m not sleeping well. Familiar abdominal anxiety without any particular thought attached. Exhausted. No racing thoughts.

With a hypo I take a little seroquel and reset. I know what to do.

What do you do if you start to cycle into a depression? Would a short term AP help with that as well?

(I might be psyching myself out. I’ll reach out to my psyche if this continues.)

Thanks for reading.

Hey, in Shitshow, there’s a line I wish someone would fucking kill Tony

Who’s Tony? Thanks!

Edit: solved! Glad I asked this sub. I wonder why the band isn’t more popular.