Had a meeting with the psychiatrist today. We had lots to talk about. I told him the adderall is failing and I was hit with a huge depression late Wednesday night from the casodex. (My wife woke up about 5:30 AM to find me reading my iPad in an attempt to get some distraction from the nearly overwhelming depression. I was so happy she woke up. I desperately wanted to talk with her, but in that state I felt like such a burden I couldn’t possibly wake her up. We spent a lot of time talking, mostly me talking, she’s such a great listener. I finally calmed down and went to sleep.)
The shrink and I agreed on a near term, mid-term, and long term treatment strategy. Near term (for the next couple weeks or so), my evening adderall booster is being changed to an extended release booster. Mid-term I’m ramping down the anti-depressant pristiq and switching back to viibryd. After a week on viibryd, I add geodon to the mix. Way back, these two drugs produced the best results I’ve ever had. But I had problems with nausea and jaw clenching. He’s hoping that if we add an anti-nausea pill, such as phenergran (or maybe zofran) that may remove both side effects. We’ll see. Longer term (starting in a month or so), I’m going to try trans-cranial magnetic stimulation (TMS). As it sounds, it involves stimulating the brain with magnetic pulses. It’s pain free and has very few near or mid-term side effects that occur with any significant frequency (in my opinion). Long term effects aren’t really known, but that doesn’t matter for me. If I get the maximum benefit from it, I may no longer need anti-depressant meds. Nice. Then again, it only provides any kind of significant relief about 50% of the time. I figure what the hell.