Just wanted to post my updates now that I've tried things for a couple of months. I have not noticed much change. And I've tried many medications, nootropics, therapy, exericse. Not sure what to do. I kind of baffle everyone.
Labs: I had high HPHPA. Took Vanco. Levels decreased. Still left with attention/mood/anxiety issues. Had low vitamin C. Poor CYP2D6 metabolizer. I did get 23and me done, but unclear to what value the SNPs can be navigated and made actionable. I've heard many mixed opinions, and my MD only regards them as valuable when looking at pharmacodynamics.
Context: Made it to college where my hard work and systems broke down and I was diagnosed with ADD/depression/anxiety. I map to Amen's Brain type 8 if that's a helpful comparison. I have trouble planning out my thoughts before getting them onto the page. It's easier for me to think in blocks/chunks of text than be driven by ideas. This creates a mess when planning my life. Hard to integrate and learn from prior knowledge/experiences. I can't focus on a larger direction. I often rehash issues because I have such a poor memory. I also meander when thinking about topics, can't just pick out the relevant details, but end up wading through a lot of noise.
On the other hand, I've had sporadic success. It's sporadic and I can't implement the systems I need to achieve consistent professional stability and success. My brain is like etch a sketch. If I can get someone/something to prompt me, I can sort of think more organized and coherently. As an adult, these prompts aren't really that feasible to generate and maintain a healthy level of functioning/self feedback. I can't just go around blurting out thoughts and handing terrible papers for people to review. I wish I could process more of my own raw thoughts with less effort. I can't take advantage of therapy because I am so near term focused/frustrated. Same thing happens with a hurt knee. I can't stick with the process and see that there's something else ahead. For my attention issues, there really hasn't been anything else.
Anxiety/Emotionally, I have a terrible self esteem, negativity and frustration tolerance with my attention issues. I get really hopeless/discouraged. But an event can shift/refocus my attention, for better or worse. So prompt based.
Overall approaches:
I try working with an add specialist and my anxiety issues are hard to address. Or I try dealing with an anxiety specialist and my add issues aren't addressed. No specialist has been able to reasonably look at both. And everything is prolonged trial and error.
In the past several years I've tried:
Combo of Pristiq/Intuniv --Intuniv seemed to help initially, but I could never go past 2 mg as I get hypotensive.
Combo of Pristiq Intuniv/Strattera--Seemed to help, but strattera introduced crying jags when I get frustrated. Had to stop at 40 mg Strattera because of exercise induced tachycardia/and high baseline HR. Went off intuniv and Pristiq to minimize tachycardia and the amount of drugs.
Adderall--Way too anxious
Concerta--helped but way too hyperfocused and anxious, didn't help with executive function that much
Wellbutrin--Made way too anxious, slightly helped.
Concerta/Prozac--Too hyped up, couldn't focus. Organization troubles still largely apparent
Currently:
Memantine-21 mg (with 10 days between 7 mg dose increases). Been on this for a month. Hard to appreciate any drastic difference.
Strattera-40 mg
Aetonolol-25 mg
At best, anything I've tried has helped 15% for my attention and 40% mood. At this rate, to get a 70% symptom improvement, I'd have to be on quite a few meds. Since I can't focus, I can't really evaluate the subtle improvements with each addition either. They're not huge. They're subtle at best.
1. What are people's thoughts on strattera?
2. What else could I try for the ability to plan/think long term?
3. What else for managing the emotional frustration that's so constant?