I want your doctor.
I think you would prefer someone more knowledgeable.
What is your official diagnosis?
The ones I currently focus on are ADHD (inattentive type) and depression. The depression may perhaps be better described as dysthymia, as its major feature is long duration rather than high intensity. There is almost no dysphoria, and very little anxiety. However, there's much anhedonia (primarily anticipatory, but also somewhat consummatory) and loss of motivation, interest, initiative and energy; psychomotor performance (coordination, dexterity, etc.) is impaired, although parkinsonian tremor is essentially absent; there is a degree of depersonalisation and derealisation, or in other words, a sense of diminished intensity of sensory awareness, but there are no delusions, hallucinations nor any loss of reality testing; there is a great deal of social withdrawal due to loss of interest; there is a practically complete loss of libido, although physical sexual function remains intact; there is considerable emotional blunting, although not a complete flattening.
The ADHD, the symptoms of which may also overlap with the dysthymia, is characterised by impaired concentration, attention, executive function and working memory. There are impairments in the capacity for organisation, planning and execution that are easily demonstrated by everyday tasks such as reading, writing, constructing, computing, calculating, and so on; the spacial aspect of working memory may be particularly affected, although the impairment is general enough to be seen also in logical, arithmetical, verbal, and other matters especially when the demands approach high levels.
It has lasted since at least the end of the last century, although some symptoms may have lessened or worsened - sometimes gradually as time has past, but usually in response to more or less successful psychopharmacological intervention.
Other diagnoses considered have included schizoid personality disorder (inluding aspects of other personality disorders), social phobia, as welll as depersonalisation and derealisation disorders, but depression and ADHD are general enough to account for most of the pathology.
Unless you are a schizophrenic I would drop the sulpiride, methylphenidate and gaunfacine, reduce or possibly eliminate the memantine and run the modafinil on it's own.
Really, if I received no benefit from them, I would not use them. I should also add that I do not take all of the drugs I've mentioned in this thread every single day. However, the ones you listed are the very core, and I rather skip modafinil, huperzine and pramiracetam than any of them (in fact, I've already done so for most of the past weeks).
Fish Oil? If you're not taking it you should be. Shoot for 6grams EPA/DHA a day from a high quality source such as Carlson's or Nordic Naturals.
I've never noticed an effect from that - even when taken regularly at recommended levels and above, although I admit that I've never used as much as 6 grams for any significant length of time.
Consider Rhodiola Rosea. I find it to be enormously helpful for providing energy and motivation. Too much and you will get drowsy. I take 100mgs. of a 3/1% extract twice daily.
I've been experimenting with it recently, but have noticed little if anything so far.
You need to exercise. Once you get over the inertia it gets much easier. A regular regimen of endurance and resistance training will go a long way to improving your energy and motivation levels.
You may have a point there. The problem is that I've never got to the point where it gets easy or does anything significant to my condition, except for a little increase in strength or stamina.
Honestly, a lack of motivation on that regimen should be a warning signal for you.
Of course, I wouldn't have mentioned it, if it were not of significant concern to me.
Adding more drugs to that cocktail is not thinking in the right direction.
Good luck.
Wherher more, different, or both, good luck is indeed what would come in handy. Thank you.
