I need some help in choosing the correct meds for my dxs. I am an LPN working at a Nursing Home. I have the following dxs: ADHD-combined type; Bipolar I D/O; most recent episode hypomanic, with no concurrent depression; GAD; and OCD. Additionally, I have problems c insomnia. My current meds are: Dexedrine: 20mg tid; Geodon: 80mg bid; BuSpar: 20mg tid; and Celexa: 40mg qd. I have been on:
Prozac,Ritalin,Zoloft,Zyprexa,Xanax, maybe more. I want to reduce the amount and types of meds I am on. Currently, the ADHD is doing alright c the Dexedrine, and my mood is stable c the Geodon (and less wt. gain than c the Zyprexa- which is a MAJOR CONCERN- as I am already overweight), but the OCD, and GAD seem to be outta control. I have had 2 'anxiety attacks'- sweating, nervousness, palpitations, h/a, dizinness, feeling the need to escape, extreme tremors (more than from my meds alone). If I take the benzos, I tend to get too sedated to work, so I only take them prn for acute anxiety attacks, but I need something to control the anxiety. I think the Paxil might have been helping??? but I was sweating profusely, having palpitations,h/a, diziness, etc. I don't know if the BuSpar is helping, bbut I certainly don't need the wt. gain. What about Effexor. I know that it is good for GAD, and though it has no FDA approval for OCD, I've seen internet indications of Effexor for OCD? Is there any data to support this? How strong a SSRi is Effexor? HOw does it compare to the SSRI'S? And how does the SNRI properties compare to Strattera? (not an option now, since I currently have no insurance, and am seen at the VA) How effective is Effexor in comparison c the SSRI'S in treating OCD? Will some of the properties of Geodon: SRI, NRI, 5-HT1a agonist, have a synergisitc effect c Effexor to increase the effects of Effexor on OCD and GAD? What other med choices do I have? I know SSRI wise, all I have left is Luvix, and Lexapro, and no other specific choices than Effexor again (when I was on it in the past, I didn't have as much anxiety-noe it's a greater issue)- the SSRI's, BuSpar, and the benzos. If Effexor will work for OCD, and GAD, I can eliminate 1 med- oh, BTW, I also take Temazepam (30mg) + either Xanax(0.5mg) or Trazadone(50mg) to sleep at night. Whqat choices do I have to adequetly treat ALL my d/o's with the fewest meds and the least side effects. I can't work as an LPN with the anxiety, nor can I work as an LPN, being sedated, or sweating, being dizzy, having a h/a, etc. I still have periods where I zone out at work. i work 3-11. I start zoning out @2000. I CAN'T just up and go to sleep at work- I need to be alert, and focused. And I zone out and get tired s taking any benzos- I don't know if I could work taking benzos. I have occasiontlly taken a nap @ 2200, after I've given all my residents their meds. Realistically, what are my choices. BTW, would I qualify for disability?