Well, hopefully they can improve on it, but I doubt they’ll get it nailed down to the point that there is no trial and error. Too many factors. And brains are far more varied than genes are, so two people who have the same genetic code for how their receptors work won’t have quite the same brain architecture so the chemicals will flow around a different way and do different things. Still, it would be nice if the process seemed a little more “science” and a little less “fuck it, I don’t know.”
I think this because there is massive variation in effects but not quite as much variation as there is in people. Like @shaddack says, there are genes they are looking into that govern some of the effects. So you can find other people who have similar experiences. Knowing other people out there had the same reaction to the same drug at least helps you separate drug-effects from your own mood, but in a less rationalized way, it’s just nice to know you aren’t alone.
I went through a pile of different meds a couple of years ago- all of them had side effects I couldn’t manage:
Hand tremors. Completely uncontrollable.
Un-equal sized pupils. Not great.
Memory loss (or, more accurately, inability to make new memories)
Hypothermia
And so on. I’ve been on the same thing now for two years (I think), and I’ve not moved the dose at all. Seems to be working (but my anti-bear device seems to be working too, so…). It still has side effects, but they’re… workable. I sweat at the drop of a hat. Others say that one stops, but mine hasn’t. I get hot flashes, too- but like I said, easily the best of what I’ve tried.
Try to stay patient, if you can- there are a lot of variables to go through, and it’s totally possible (likely, even) that there’s a combo/dosage that will get you the effect you need and be tolerable. Took me a while to find mine, but it’s been pretty worth it.
The main thing I’m scared about is that I can submit work that is sub-standard if I’m not concentrating hard enough (even though I do have a good reputation with the companies I work for). Normally I am good at regulating things, e.g. by checking my work on a different day when my mind is as active as possible, and making sure that I’m in the best frame of mind, well-rested etc., but the medication can give you a kind of Dunning-Kruger effect. A handful of mistakes in a single document can have a serious effect on a company’s willingness to give you work, and I have no job security. Five other people rely on my and my wife’s income, so I can’t afford to be exploring the side effects of medication at the moment. The good news is that I seem to be doing OK at the moment and I’ve finished one of the two university assignments. The next one is actually due next week, so I’ve got some breathing space before then.
Yeah- there’s nothing worse than not being able to properly tell you’re a mess. Terrible decisions come as a result.
My longer-term plan is to try to ramp up my level of physical activity. Historically, it’s been my own version of self-medication, and the side effects are (on a daily basis, anyway) far less bothersome. Time is my constraint right now, so I’m using the meds as a crutch in the meantime.
There is never a good time to be experimenting with meds/doses- it’s a matter of prioritizing how critical that aspect of life has become for you. I had to go through the ugliness of finding the right thing (and it was not the right time in my life for doing that…), but it was a urgent enough problem that it had to override most other aspects of my life. Just the way it was.
I second this. This applies to both school and life in general.
Do you know anyone who is doing very well in your class? Sometimes if I’m stuck professionally, just talking to someone about the way they’d approach what I’m doing is super helpful.
Given your approach to life, you’ve probably researched this already, but a lot of psychiatrists don’t seem to know it, so:
If you stop the Effexor, it’s very important to taper it off slowly, and be prepared for a rocky time anyway.
Because it’s an SNRI (serotonin and norepinephrine uptake inhibitor) not just an SSRI, when one stops taking it, the norepinephrine (aka adrenaline) and dopamine levels plummet, in addition to serotonin levels dropping. If you stop it suddenly, or for some even gradually, the result can be similar to giving up a cocaine or amphetamine addiction cold turkey. I’ve coached a couple online friends through that situation, when their doctors were apparently totally oblivious of the possibility. Idiot shrinks.
Knowing that, you can counter it to some extent, both by adding some mild stimulants - drink extra coffee or tea or whatever you can stand - and just by knowing what’s going on.
I bought a Nissan Versa a couple of weeks ago. I’ve had the car less than 10 days and I get rear ended at a stop sign. I get out to look at the damage and the lady that hit me gets out, in a cop’s uniform on her way to work. I swear, first thought that passed through my head was that somehow I’m going to end up in jail over this. Shit.
We’re fine. Ms Tachin will be wearing a cervical collar for the next couple of weeks and is on pain meds, but is otherwise OK, fortunately Tachin jr inherited my sturdiness and was protected by some seriously bad ass genes.
Minor scratching on the rear fender and I can’t open the trunk because its hard to close now, fortunately the insurance will cover it and should be fixed soon but man, I still haven’t made my first payment on the car and this shit happens. fuck fuck fuck fuck fuck.
So I went to my shrink today. Got the antidepressants upped, now in the SNRI land (welcome new side effects, I have time booked for ya). Let’s see how it will work now.
Asked for modafinil; literature says it is widely used in depression treatment where the other meds only partially. Own experiences with an unofficially sourced material confirmed it works for me pretty well and makes me alert and willing to get up and do stuff. However, some eurobureaucrat from some euro pharma commission or how’s that nest of ass-covering geezers called, decided that the minuscule risk of fatal side effects, with probability comparable with getting hit by a lightning, is Too High - even if grossly overcompensated by lowering the risk of me absent-mindedly walking under a bus. And they, in their infinite wisdom, decided to restrict availability; so now only a neurologist can prescribe it, and only for sleep lab test confirmed narcolepsy. So I can not legally and officially get it.
And the friend who sourced it for me before turned out to be less than reliable, twice in row taking my money and delivering nothing. And the thing is Expensive so the loss is considerable, even if I don’t count the loss of trust in him.
So I am effectively forced to black market, with all its associated risks and inconveniences. Great, very great. Added cost, added risk, and I have to do the quality control myself, which means some social engineering to get access to a local uni’s GC-MS rig and extract a pill into methanol and compare the spectra with a known-good sample. I roughly know how to operate the chromatograph and interpret the results as I worked with it two decades ago for about a day, and covet it since.
Or to cook it myself. The synthesis is not entirely straightforward but also not prohibitively complex… and in that case I get pure product which can be tested by crystal shapes and by their melting point and melting behavior under microscope, not even requiring specialized instrumentation.
The world keeps giving me tastes of good things only to yank them away again. Whether love or meds. At least the meds are easier to source, even when difficult to source.
Fuck the EU and its suit’n’tie parasites that spoil my day.
Here’s a pro tip, Adrafinil is a mostly unregulated prodrug for modafinil, and is generally even better tolerated. The downside is that you have to take 4-10 times as much to get an equivalent effect to modafinil.
I am not sure adrafinil is better tolerated. My research says it has more side effects and prolonged use can elevate liver enzymes. Which makes it a harsher, secondary option to modafinil itself.
It is certainly easier to source, though. I forgot about this possibility, thanks!
I consider confidence a double-edged sword. As an engineer, when you feel it, it is a marker that you missed something and it will bite you now or a decade later. Confidence is a bad master that leads you to half-assed testing; avoid it.
…of course females seem to want and value confidence. Oh well…
The confidence I get from stimulants is purely selfish. Really, it’s very close to, if not the same as mania. If I’m actually addicted to anything it’s the feeling that everything I’m doing is right, that I’m having good ideas, the feeling that people like me, and that I have the ability to do whatever it takes to achieve my goals. I don’t get that in every day life. I get it out the wazoo on dopaminergic stimulants.
I’ve been badly abusing some molecules for the past several months. Today is the day I get to detox (partially observed by my doc, he agreed with my plan and med schedule).
My skin feels like it’s on fire. My heart is racing, and I’ll bet my BP is at ungodly levels. Thank fsm I have a stock of Xanax, klonapin, and gabapentin. I made a promise to my shrink, and he is gonna hold me accountable.
Turns out that our cat’s broken bone was cancer (or possibly a rare fungal infection). Either way it means that he will be getting his leg amputated.
The difference between his January x-ray and today’s is striking – most of his metacarpals are disintegrated. He’s an incredibly tough ol’ street cat, so I’m not too worried about him pulling through. Just wish he didn’t have to deal with the pain.
