Further to this earlier post, we have been diagnosed with combined type ADHD, and we're going to be started on 30 mg lisdexamfetamine daily, which will replace the 150 mg bupropion extended release we've been using as a stand-in whilst waiting for the ADHD assessment.

This doesn't replace our diagnosis of Autism Spectrum Disorder (ASD) from 2018, so our medical records will formally show us as both autistic and ADHD   

We didn't need the diagnosis to know that we were AuDHD, but we did need it in order to get the prescription for lisdex, which will hopefully help us a little bit with executive function, and hopefully better than the bupropion has been doing 🤞

#ActuallyAutistic #ActuallyADHD #ActuallyAuDHD #autistic #ADHD #ASD #AuDHD #bupropion #lisdexamfetamine #neurodivergent #neurospicy

Per our post yesterday, we emailed the practice manager at our NHS GP surgery last night, enquiring about switching from paroxetine to another antidepressant medication.

We've reduced our paroxetine dose from 20 to 10 mg today in preparation for a change in medication. To counteract any ill effects, we're resuming taking half a tablet (75 mg) of bupropion extended release alongside. (We had to acquire this off prescription, as the NHS won't prescribe it for treating depression.)

If we can get a sooner appointment with the senior partner or another GP at our GP surgery to approve starting on something like vortioxetine (10 mg) or another suitable medication, we'll discontinue the bupropion. If not, we'll fully come off the paroxetine and continue with 75 mg of bupropion daily for a while.

#depression #MentalHealth #paroxetine #vortioxetine #bupropion #SSRI #SMS #NDRI

Hey folks  

It's been a while since we did a public update post on our mental health, so this is kind of overdue 

In short, we are presently still struggling with depression, anxiety, and executive dysfunction most of the time. We have, however, seen some gradual improvements soley due to being signed off work, which is a major stressor.

Because we're still struggling, we asked our GP to look into potentially changing our prescription antidepressant from sertraline (max dose of 200 mg daily) to something else. He advised he'd look into it.

Meanwhile, we decided to take a look for ourselves, using the data on the binding profiles of various monoamine reuptake inhibitor and checking which ones are listed on NICE. For any that were, we further checked that were licensed for use as an antidepressant.

After all that work, we basically realised that sertraline was likely the single best out of all the ones the NHS can prescribe, followed only by paroxetine  The major difference between the two is that paroxetine binds more to noradrenaline transport receptors, whereas sertraline binds more to dopamine ones. Both otherwise are fairly comparable.

We had been very much hoping that the NHS might prescribe some kind of balanced SNDRI antidepressant to boost our serotonin, noradrenaline, and dopamine levels roughly equally. However, whenever we found one, we found that it wasn't available on the NHS AND it had a lot of bad side effects  

E.g.,

• butriptyline
• nefazodone
• sibutramine

As an additional note, we have been taking a low dose (150 mg daily) of bupropion alongside sertraline for a while to try to get more executive function. We don't even have a date for an ADHD assessment yet, so we aren't able to try the main ADHD meds, as these are all controlled substances.

We were able to acquire and try atomoxetine alongside sertraline (in place of bupropion), as it's not a controlled substance, but this did not go well at all 😞

Our research indicated that it'd be better for us to try another single antidepressant medication than keep combining sertraline with bupropion, as that comes with a higher risk of serotonin syndrome and seizures. Plus we'd need to come off bupropion anyway in order to try any other ADHD med.

As such, we're going to steadily reduce our bupropion dose and come off this by the end of the week. We'll then see how we fare.

In terms of setting reasonable expectations, based on our sensitivity to atomoxetine and other stimulants, and the fact that we're AuDHD, we do not expect either of the main two ADHD meds (methylphenidate and lisdexamphetamine) to work well for us 😔

All we can do right now is try to focus on getting the depression and anxiety under control, so that we can try to develop strategies to cope with and work around our lack of executive function.

#MentalHealth #depression #anxiety #ExecutiveDysfunction #ADHD #AuDHD #neurodivergent #neurospicy #sertraline #bupropion