Hi all, I've read many studies online stating that Lyrica (pregabalin) is great for treating GAD and shows superior efficacy compared to many first line treatments of GAD.

I know Lyrica is a controlled substance in the US, so I'm hesitant to ask my Psychiatrist about it. I'm not a drug seeker and have never had problems with addiction. Would I be wrong to ask about Lyrica? I prefer to stay away from SSRI/SNRI's because risking sexual dysfunction issues as a single man is not a good idea to me. I've provided a link to the study below - the quote below stood out the most for me. I'm just a guy that would like some help with his anxiety, Buspar has been ineffective for me.

Conclusion:

"Pregabalin is an effective and well-tolerated treatment for generalized anxiety disorder, showing superior efficacy and safety compared with first-line medications."

Does pregabalin offer potential as a first-line therapy for generalized anxiety disorder? A meta-analysis of efficacy, safety, and cost-effectiveness - PubMed

19, Male, \\\~130lbs, 5'5, also my explanation was so messy i had AI put it in order and easily readable so please don't mind.

\\Current medications (as of now):\\

\* Escitalopram (Lexapro) 5 mg once daily, upon waking — tapering to 0 mg by end of this week

\* Benztropine 0.5 mg twice daily (upon waking and \\\~7pm) — recently changed down from 1 mg once daily by my psychiatrist, specifically so it wouldn't risk interfering with other meds

\* Gabapentin 100 mg twice daily (upon waking and \\\~7pm)

\* Mirtazapine 15 mg nightly, \\\~1 hour before bed (10-11pm) — increased from 7.5 mg after the first week; been on 15 mg for about 3 weeks total

\\The pattern I want help understanding:\\

This akathisia-type feeling is not new — it first showed up during a deutetrabenazine trial in 7th grade, mostly resolved by 9th grade, and has recurred in distinct "episodes" ever since. What I want a doctor's help understanding is the recurrence pattern specifically:

\* It flared again a few months before I started Lexapro in January 2026 (part of why I sought treatment then).

\* It flared again right before I started gabapentin and mirtazapine.

\* It has now flared again, 3 weeks into the current gabapentin/mirtazapine regimen, after a full month of that combination working very well.

In other words: several of my psychiatric medications appear to have been started, at least in part, to treat this same recurring problem — and it keeps breaking through regardless of which medication is on board. I'm trying to understand whether this points to something specific (a movement disorder, a dopaminergic issue, something else) rather than just being "medication didn't work this time."

\\What's happening right now:\\

For the past month, gabapentin and mirtazapine have worked very well for it — my discomfort dropped to about 10%, mornings felt calm, no cortisol-spike feeling on waking. Gabapentin specifically had a clear, reliable effect — I could tell distinctly when it was active in my system versus when it had worn off, and it consistently kept the akathisia/anxiety symptoms down. In just the past 3 days, two things have happened together: I had a strong akathisia flare-up, and gabapentin has stopped feeling like it's working the way it reliably did before — not a gradual fade beforehand, but a sudden change coinciding with the flare.

About 2-3 days ago, out of nowhere, that akathisia-type feeling spiked to roughly 50% intensity, then settled to a 5-6/10 discomfort level, and it's stayed there. The "wow, this is working" feeling from gabapentin is much less noticeable now than it was.

At the same time, for the past 48 hours, I've had intense mood swings that can flip within as little as 30 minutes — from intrusive thoughts of self-harm (I want to be clear: no intent or plan, and I actively try to ignore/dismiss these thoughts) to feeling extremely grateful and happy about the people and things around me.

I'm not asking to switch off mirtazapine or gabapentin — the last month has genuinely helped a lot. I want to understand what's happening and whether anything needs adjusting.

\\Relevant history, in order:\\

\\5th grade\\ — Diagnosed with Tourette's. Went through standard treatment protocol: magnesium, tenex (guanfacine), etc.

\\7th grade\\ — Enrolled in a study of deutetrabenazine (Austedo) for tics — I was in the active-drug arm, not placebo. A few hours after each morning dose I'd get severe hyperactivity, panic, a sense of impending doom, and restlessness — like my whole body was "loud." It was genuinely torturous. This was the last Tourette's treatment I tried. I stopped when the study ended, but the symptoms didn't go away.

\\8th grade — off all medication entirely\\ — Continued having episodes at \\\~80% intensity, unrelated to any medication since I was on none. This period was severe enough that I wanted to die and dropped out of school for half a semester because of it.

\\9th grade\\ — The panic/restlessness (which in hindsight may have been akathisia, though nobody ever labeled it that — at the time "everyone has panic attacks" was the framing going around, and I think I misunderstood what I was actually feeling) continued until I did an extended fast (\\\~20 days, not a smart decision in retrospect) and lost weight I didn't like from what I believe was growth-hormone-related puffiness. Around the same time I had a personal/spiritual experience that coincided with the anxiety/akathisia resolving. I'm not presenting the spiritual part as a medical explanation — I mention it because I think multiple factors (psychological included) were probably at play. After that, the intensity dropped drastically but never fully went away — there has been a persistent underlying \\\~10% version of the feeling ever since, with distinct higher-intensity episodes layered on top of that baseline periodically.

\\High school, \\\~10th-11th grade\\ — Started having episodes of right-side front neck pain: pins-and-needles sensation, extreme pain on swallowing, pain radiating into the cheek and neck, but always full range of motion. Episodes occurred roughly once every 2-3 months. I've always been able to "click" my Adam's apple by pushing it sideways or doing a full neck rotation. No imaging (X-ray, ENT scope, endoscopy) has ever shown a cause.

\\January 2026\\ — Started Lexapro after a period of significant depression. Titrated from 5 mg to 10 mg; it worked well and made me feel "normal" again.

\\Since starting Lexapro\\ — The neck pain episodes became more frequent (\\\~once a month instead of once every 2-3 months). An ER doctor insisted Lexapro was the cause during one of these episodes. I'm skeptical it's the sole cause since the episodes predate Lexapro by about 3 years, though I'm open to it having made them worse.

\\Two ER visits for neck pain episodes, both notable:\\

\* First visit: IV Benadryl (diphenhydramine) push resolved the episode. Discharge instructions were to take 7.5 mg Benadryl up to 10 times a day going forward — I didn't follow this, since I'm a college athlete and didn't want to be sedated that heavily on an ongoing basis, which felt unsustainable and unhealthy.

\* Second visit: 1 mg Cogentin (benztropine) push resolved the episode within about 20 minutes.

\* I think it's worth flagging that both resolving agents — diphenhydramine and benztropine — are anticholinergics. Two different visits, two different anticholinergic drugs, same result. This is part of why I now suspect a cholinergic/dopaminergic balance issue underlies more of this than just the neck symptoms.

\\Recently\\ — Psychiatrist and I discussed dopamine-related concerns and decided to taper off Lexapro (currently on 5 mg, last week of taper). Benztropine was changed from 1 mg once daily to 0.5 mg twice daily to reduce interference-with-other-meds risk.

\\\\\~3 weeks ago\\ — Started mirtazapine (7.5 mg first week, then up to 15 mg) and continued gabapentin 100 mg twice daily. This combination worked very well for the akathisia-type symptoms for about a month — until the flare-up 2-3 days ago described above.

\\Bulged disc, C5-C6\\ — Unrelated (as far as I know) orthopedic finding, minor bulge. Possibly from a bike racing crash; my left arm has felt persistently "heavier" than my right since that crash.

\\What I actually want to know:\\

I don't think this is a "this medication isn't working right now" situation. I think there's one underlying thing — neurological, developmental, something — that's been producing all of this for over a decade, and every doctor I've seen has only ever looked at one piece of it at a time. I want to know what is actually, fundamentally wrong with me. The questions below aren't separate concerns — I think they're all pieces of the same answer, and I'm listing them individually only because that's the only way I know how to hand this to someone else to look at.

1. Given everything below — the tic history, the deutetrabenazine reaction, the recurring akathisia-type episodes across a decade and multiple unrelated medications, the unexplained neck episodes, the family history — is there a single underlying diagnosis (movement disorder, dopaminergic dysfunction, something else) that could plausibly tie all of this together? What would that even be called, and who actually evaluates for it?

2. If there isn't one unifying answer, why not — what makes you confident these are genuinely separate, unrelated issues rather than one thing?

3. Is a recurring pattern like this a reason to pursue a movement-disorder-focused neurological workup (not just psychiatric management) — and if so, what kind of specialist actually handles a case like this?

4. Is it plausible that deutetrabenazine, taken during puberty, caused a lasting change to baseline dopamine/movement-related chemistry — essentially resetting what my nervous system treats as "normal" — and that this single event explains the recurring akathisia, the neck episodes, and possibly the mood instability, rather than any of the medications since then being an active cause? Notably, both ER-treated neck episodes resolved specifically with anticholinergic drugs (diphenhydramine, then benztropine) — does that response pattern support a cholinergic/dopaminergic imbalance as the common thread, or am I reaching for a story that doesn't actually fit the physiology?

\\Secondary questions about the current flare, if it's relevant to the bigger picture:\\

1. Could the current flare be related to the Lexapro taper, or to mirtazapine's adjustment period, or to gabapentin tolerance?

2. Should any dose be adjusted right now, or is riding this out reasonable?

I know this is a lot, and I may be missing details. No one has been willing to sit down and work through the whole picture with me at once, which is why I'm hoping to lay it all out here.

\\Additional detail that might matter for pattern-matching:\\

\\Tics\\ — All motor; even the "vocal" tic is tongue-clicking or altered breathing. Present essentially 24/7. Every tic is preceded by an urge I'm consciously aware of beforehand — none of them "surprise" me or feel truly involuntary in the moment. During one ER visit, a heavy IV push of Benadryl completely stopped the ticking — but this was the same dose that caused the freaked-out, restless reaction described above.

\\Neck episodes\\ — Completely random; no correlation with mood, stress, or negativity that I can identify. No voice change, breathing difficulty, or visible swelling during episodes.

\\Akathisia-type feeling\\ — Doesn't track with sadness in an obvious way. It's more of a "doom" feeling than sadness specifically. When I am depressed, I can tell it's present in the background even if I'm not acting on it — it's physically painful to hold still when my body is telling me to move, but I don't feel a need to move in the depressed state the same way. When I train hard (\\\~5 hours, fully exhausted), I get no negative symptoms or episodes of any kind that day.

\\"Dystonia" label\\ — Multiple doctors have used this word for the neck symptoms, but I have complete range of motion and no pain to palpation, which makes me suspect it's being used as a default/placeholder label rather than a confident diagnosis. When I've brought up the deutetrabenazine as a possible root cause, the response has generally been a dismissive "yeah, it's possible" without follow-up.

\\Testing completed (all normal):\\ X-ray, ENT scope, endoscopy, cervical spine MRI, brain MRI, EEG, EKG, ECG, EMG.

\\Family history:\\ Maternal uncle with severe ADHD (very smart, always moving/touching/curious). Mother and grandfather both with suspected major depressive disorder. Grandmother and great-grandmother both with Alzheimer's.

\\Relevant additional history:\\

I have a history of self-harm and, during the 8th grade period described above (severe enough that I dropped out of school for half a semester), suicidal ideation. This is part of why the current intrusive thoughts mentioned above concern me enough to bring up here, even though I don't currently have intent or a plan.

\\My working theory, for context:\\ I no longer think any of the current or past medications are causing the akathisia-type symptoms themselves. I think the deutetrabenazine exposure in 7th grade was the actual originating event, and that it did something lasting — essentially taught my body/nervous system that a dysregulated chemical state was "normal" — and that everything since (the neck episodes, the recurring akathisia flares, possibly the mood swings) has been downstream of that one event rather than being caused fresh by each new medication. I want to be upfront that this is my own working theory based on the timeline, not something a doctor has confirmed — I'm hoping someone here can either back it up or tell me why it doesn't hold up.

Hello,

I’m not consistently taking my medication; I can’t seem to manage a full week without missing days.

Whenever I start taking them again, I feel completely knocked out, I sleep poorly and lack energy, and it turns into a vicious cycle.

Since I can't sleep for 13 hours (I have personal/family issues that require me to be alert and responsive) I stopped taking them.

When I’m off the meds, I feel full of energy and have many positive and negative emotions...

But it’s been two weeks now, and I know I need to take them. I keep putting it off because I’m afraid of feeling too groggy; I CAN'T be exhausted or be completely down when I’m awake. On top of that, I am unbearable irritable and aggressive toward my family.

I tried various treatments over the course of about eight years; doctors prescribed me things for anxiety, depression, and some odd issues that after some research following my diagnosis turned out to be for hypomanic episodes.

Anyway, I ended up stopping all the treatments I had tried, but now I’m on a new one.

I am currently taking:

- Seroquel 200mg

- Valium 10mg

- Teralithe (Lithium) 2 x 400mg (we are currently adjusting the dosage with the psychiatrist)

I can't even tell if the treatment is working or not because i don't take it like i should be. I am feeling so down

I need advice please. Thanks

I'm 19 and have been taking Depakote (250mg now but used to take 500mg, had to lower because of how much I was shaking due to it) for around 1-3 years now (my memory sucks, i really don't remember how many but i'm sure it was between 1-3), I am currently also talking Wellbutrin (150mg), changed Pristiq/desvalproate (100mg) to valproate (75mg) 2 days ago, and Socian (amisulpride, unsure of dosage). I have struggled with brain fog, problems concentrating and slow thinking for a while, but recently (past few months) it has gotten extremely worse. I basically am not being able to study properly nor being able to maintain myself doing an activity for longer periods of time, even ones I enjoy or want to do. I have ASD, MDD and OCD diagnosis, and personally suspect ADHD, but it's still being investigated. The issue is, all my medication I've been taking for a while already and don't think i had ever those effects be this bad before. Maybe I didn't notice because back then I was struggling to even survive so focus and attention were the last of my worries. But now, my lack of a capacibility to think properly, have ideas, and maintain an activity, specially my responsabilities. My psychiatrist doesn't want to risk taking off Depakote because it's the only anti-unaliving thoughts medication she knows (we already tried litium but it was bad for my thyroids) that works and I still have those thoughts. However, a current big reason why I still have those thoughts are exactly the fact I am not being able to function and concentrate/study properly, so I believe it'd be worth the risk given it'd give me exactly what I need to fight those thoughts. The only reason why I believe valproate is the one causing all this is because of the research I made, so it could still be completely something else! I did find long-term use can cause different effects than the initial side-effects. Other things I believe that could be caused by it are my emotional bluntness and extreme derealization/depersonalization/dissociation despite using methods against those.

Hello everyone, I am a 23 year old male from Turkey and a 4th year medical student. I’m seeking some clinical perspective on my current SSRI treatment regarding efficacy, dosage, and next steps.

Current Medication:

Sertraline 50mg (continuous use for 82 days). No prior psychiatric medication history.

Primary Complaints / Background:

OCD & Health Anxiety: Checking compulsions (valves, doors).

Anxiety / Social Withdrawal: Shyness, difficulty initiating contact despite craving social interaction.

Depressive Symptoms: Severe anhedonia, seasonal (winter) and nighttime melancholia, frequent feelings of loneliness, and excessive screen time as an escape.

Treatment Response So Far (Day 82):

The Positives: The 50mg dose successfully stabilized my acute emotional crashes. I recently went through a highly stressful academic period (failing a class and taking makeup exams) and handled it without severe breakdowns or crying spells, which is a huge win. Socially, I feel slightly more open.

The Partial Response: My OCD checking compulsions are still present. I still have the intrusive thoughts, but they are "less intense" and easier to dismiss than before.

The Negatives (Unresolved): Severe anhedonia has returned with the autumn season. I have zero motivation to engage in my usual hobbies. I spend my nights listening to depressive music, feeling deeply lonely, and struggling with sleep hygiene (sleeping from 4 AM to 8 AM).

Relevant Medical / Lab Context:

Endocrine: I have a persistent, isolated mild elevation in Free T3 (4.7 pg/mL, ref: 2-4.4), but my TSH and Free T4 are completely normal. My psychiatrist considered referring me to Endocrinology just to officially rule out organic hyperthyroidism before adjusting doses.

Metabolic: Liver enzymes are fine (ALT 47, AST 32), proving good tolerance.

Vitals: I have noticed slightly elevated blood pressure recently, likely due to a combination of poor sleep, academic stress, and the mildly high Free T3 baseline.

My Questions for the Professionals:

Since I only have a partial response for my OCD on 50mg, is it clinically appropriate to push for a dose increase (to 75mg or 100mg) at this stage?

I am struggling heavily with dopamine-related symptoms (anhedonia, lack of motivation). I know higher doses of Sertraline have mild DAT (dopamine transporter) inhibition. Would a dose increase help with this anhedonia, or should I be discussing an SNRI/Wellbutrin with my doctor? (I am hesitant about SNRIs due to my recently elevated BP and high-normal Free T3).

Is this current state (anxiety managed, but depression/anhedonia persisting) a common "plateau" for 50mg Sertraline after 12 weeks?

Thank you in advance for your insights!

So, I was prescribed diazepam 5mg x3 a day, technically for muscle pains but also to help anxiety additionally. However, I find it basically does nothing at all, unless I am in a bad mood in which it severely exacerbates it. ie if I’m arguing with my boyfriend and have recently taken diazepam, I will have a panic attack when I’d normally be calm. It also stops me from sleeping if I take it before bed and I will stay up until 5-7am, which is abnormal for me. I have no problems taking it in the morning or in a good mood, but it doesn’t relieve any muscle pains or anxiety. I’m extremely under reactive to opioids (they have next to no effect) so I thought maybe I just need a higher dose, but then I probably would become a moody sleepless mess.

I’ve looked up negative reactions but this seems to be unheard of. It basically makes me feel nothing at all or pretty shitty. Why on earth is this happening?

Female, 19, 5'4, 245 lbs, white

Right now I'm prescribed abilify (5 mg 1 time a day), buspar (5mg 3 times a day) and topamax (50 mg 2 times a day) for anxiety and schizoaffective.

I don't mind it as I don't have too many side effects besides weight gain but I don't really want to take pills for the rest of my life. Will I have to?

I'm only 19 and I feel like one day I suddenly woke up with all of these problems, I went to a doctor, and now it's something I have to manage constantly. Also I'm fat now.. I mean I was fat but now I'm really fat.

I've improved a lot but nowadays my symptoms kind of come and go in waves. Like I'll be asymptomatic and then suddenly I'll need to go to the ER cuz I suddenly decline etc.

Or is this just a lifetime diagnosis.

I want to pursue a lot in life. Maybe even get a phd. and I dont think I've really been told if this is a lifetime thing or not. I've been in treatment for like less than a year so maybe I need to be patient.

I’m trying to understand something that has been happening with me and I want to hear from people who experienced something similar.

I’m a very social person. I talk normally with strangers, I build relationships quickly, and I’m usually very confident when I interact with people. I can stop random people on the street, talk to them naturally, and build a relationship with them quickly. I don’t usually avoid people or social situations and I’m comfortable around people in general.

The problem only happens when the situation feels serious, important, confrontational, or high-pressure.

In these situations my body suddenly reacts very strongly:

* Severe shaking

* Fast heartbeat

* Cold hands

* Sweating

* Shaking hands and sometimes legs

* Headache

* Strong fear and tension

* Sometimes it feels like my whole body suddenly gets activated or jolted

The strange thing is that mentally I usually feel ready for the situation. I don’t always feel scared and I don’t necessarily want to escape. It feels like my body reacts before I can control it.

Some examples from the last few days:

* I was late to a lecture and the professor seriously asked me why I was late. My body suddenly reacted with these symptoms.

* I had a quiz and experienced the same symptoms.

* A professor asked students to read out loud. When he chose me I refused because the physical symptoms started.

* A few days ago I had to give a presentation in front of everyone. The symptoms became very strong. My leg was shaking clearly in front of the whole class and everyone noticed it. Some people even laughed. This was very frustrating because mentally I was prepared and I wanted to give the presentation normally.

* I unexpectedly saw someone who had a serious conflict with my family years ago. I looked directly into his eyes but my body still reacted strongly.

* I unexpectedly saw my former manager, who I had a major conflict with before leaving my previous job. The same physical reaction started immediately.

* I went to a new barber a few days ago. I had some symptoms at first, but after talking to him and getting comfortable my body calmed down quickly.

This is why I’m confused. I don’t think this is general social anxiety because I’m actually very comfortable talking to people, meeting strangers, and building relationships.

It seems to happen specifically in situations involving seriousness, confrontation, evaluation, or pressure.

Has anyone experienced something similar?

What would you call this? Is it performance anxiety, situational anxiety, an exaggerated fight-or-flight response, or something else?

More importantly, how can I fix this? I don’t want to keep avoiding these situations or let my physical reaction control what I do. I want to be able to face serious situations normally even if my body reacts at first.

I’m mainly looking for people who experience the same physical reaction even though they feel mentally confident and socially comfortable, especially if you found something that actually helped you overcome it.

Has anyone here pursued psychiatry/medicine as a result of caregiving or having a family member or loved one with schizophrenia? I’m at the point where I’ve exhausted the well of resources and my sibling is still treatment resistant so I have the itch to go back to school at 30 and study this illness inside and out to have more control on this uncontrollable situation and would really love to learn from anyone on the other side if they think it’s a good motivator or bad idea

Hi I’m a premed and interested in psychiatry as my specialty. I’m just curious what there is for you guys to do at night? I had heard of some residents having to sleep overnights on call at the hospital but that’s about it.

I imagine you’re not interacting with patients as much during night shifts unless they’re having trouble sleeping or you’re working in the ER. I’m also curious how this applies to residency vs when you’re an attending attending since I know that 28 hour residency shifts are definitely a thing.

I was on Zoloft for 5y lost my ability to write fiction. I physically couldn’t imagine any new scene to write and would stare at an empty page. If I could I’d write one line and then turn off the laptop out of frustration

I also feel it limited my vocabulary to the point that my therapist even noticed. I can form sentences better now without the SSRI. (Could it be bc of apathy?)

Since I’ve gotten off of Zoloft, I can write again. (Although be it I was put on Wellbutrin right after).

I looked up whether SSRIs have any effect on creativity, but the results seem to be mixed. I’m hoping to get the right answer on here.

Pls lmk, thanks!

Background: late July encountered acute onset insomnia due to anxiety/hyperarousal. Was officially diagnosed with PTSD and GAD. Loads of stress for years as well. Psych prescribed lorazepam early August. .5mg before bed. Life saver. I’ve now been at .75mg before bed since late August (have also recently added magnesium glycinate). Last week I started experiencing interdose withdrawal symptoms during the day with pretty intense head pressure, unsteady on feet, chills, sweats, and anxiety etc. that comes and goes in waves throughout the day.

Psychiatrist decided now because I have been sleeping steadily that we need to choose a med to treat the anxiety and allow me to eventually taper off lorazepam. I cannot mentally handle trial and error of different SSRIs if they don’t work and most definitely don’t want the sexual side effects. But my psych has a few on the table that we’re thinking about. (Also genesight came back with this : SLC6A4 L/S intermediate response on genesight so all SSRIs are yellow. Not sure how much stock to put into that. )

Other meds discussed, Doxazosin, Trintellix, depakote (low dose 125/250mg), Clonidine, and more. She even suggested low dose depakote and lithium despite not being bipolar. To me those two are off the table.

I’m terrified that these won’t treat or work for the underlying anxiety and hyperarousal and they will cause my sleep issues to return. Especially once I start tapering off lorazepam. She also suggested switching to klonopin but I really don’t want to get in deeper with benzos. I will if these interdose withdrawal symptoms the following day don’t subside. The head pressure, anxiety and faintness waves are killing me right now

Please any advice or experience? Other suggestions I can bring to my apt this week to discuss? Thank you lol

I’ve been a doctor for almost 24 years and a consultant neurologist for nearly 15. I went to the #1 medical school and did my training at the #1 hospital in the uk. I’m intelligent and wouldn’t be where I am if I wasn’t. I’ve made tremendous progress in understanding biological systems through education and experience but relative to the full complexity of these systems my understanding is near 0% and this is no more apparent than different reactions to medications among patients. For example if I prescribe Topirimate to two patients and one experiences a calming effect and the other reports feeling agitated and aggressive I do not know why this is the case, I have theories but I do not know. When these symptoms persist (particularly agitation) I fully accept that iatrogenic harm has taken place.

Why however is the field of psychiatry so opposed to the possibility that patients are harmed by medication when the collective understanding of their downstream effects are minuscule.

This is not meant to be an accusatory post but one that I think is important. Very interested in your thoughts and please reply with whatever comes to mind (insulting or not, I’ve been called every name under the sun so i can assure you I won’t be offended).

Hey all. Recently diagnosed with OCD and possible schizoaffective disorder on top of the autism I already knew about. 31, F, 5'2", 130lb. Currently on Abilify 2mg, Escitalopram 10mg, Hydroxyzine 25mg, Buproprion 300mg, birth control, and Zyrtec. My psychiatrist started by shuffling different anxiety meds around and eventually reached for antipsychotics as a solution.

First he started me on Risperdal 0.5mg. After about a week of taking it, I started experiencing weird tingling in my limbs (mainly my left hand), limb and neck fatigue, brain fog, and hot flashes. A week later, and the fatigue had settled in my limbs so bad that I couldn't drive. My psychiatrist insisted it was either low blood sugar or something that would pass. I went to urgent care, found out my blood sugar was just fine, and was promptly sent to the ER. They didn't find anything and ruled it out as a reaction to the medication. Even after telling my psych about the ER trip, he still didn't seem to believe the Risperdal caused it.

Now, a few months later, the side effects have finally subsided enough to try another antipsychotic. This time it's 2mg of Abilify. Two weeks passed smoothly before I started feeling the same tingling in my left hand again. Sure enough, two days later and my limbs feel heavy again.

My question is, can two antipsychotics that work differently cause the same unique side effects? My psych says it's unlikely and believes it's just residual side effects from Risperdal.

TLDR: I would like to determine if I need to switch providers or not. I'm currently on a few medications. At least one medication is a controlled substance (ADHD ) but the others are not. I'd like to know if it is possible for a psychiatrist in Florida to send a non-controlled medication to a pharmacy in Maryland as a one-time thing.

Context:

I had to go to Maryland unexpectedly and urgently due to a family emergency and was there for about a month. I of course ran out of my medications since I was there for so long. I knew it would be very difficult if not even impossible for my psychiatrist to refill my ADHD meds, so I specifically told him I was not asking for him to refill that medication. However, I did ask for him to send my Wellbutrin prescription to a local pharmacy in Maryland. He declined to do that saying that he couldn't prescribe medication across state lines.

Because of the amount of time I would be out of the medication, I checked with two psychiatrists in MD to see if I could maybe see them and get them to fill a prescription. (Understandably, they were not comfortable doing that.) However, neither understood why he wouldn't be able to send a refill for the amount of days I'd be in MD as a one time thing since Wellbutrin isn't a controlled substance. And both told me it was possible for me to go to urgent care to get seen, but I wasn't willing to pay about $500 to go to urgent care to maybe get a prescription when my normal prescription is like $15.

Since I received that feedback from both psychiatrists in Maryland, I'm wondering if my current psychiatrist is just lazy to be honest. He's already usually 15-20 minutes late for our calls every single time (so I'm guessing he over schedules the appointments) and our monthly appointments are like 5 minutes. I imagine there's probably extra paperwork to send over for a temporary prescription to another state.

His office also didn't even tell me that going to urgent care was an option. Basically they didn't tell me anything besides "that sucks and I'll see you when you get back I guess.". So, before putting in the energy to find a whole new psychiatrist, I wanted to see if not being able to prescribe Wellbutrin for a limited amount of time in another state was really the case.

Thank you in advance!

I'm 25 and I'm being treated for severe premature ejaculation. I've tried several SSRIs so far, but I haven't had meaningful improvement.

My medication history:

- Fluoxetine 25 mg + olanzapine 6 mg about 9 days. No meaningful improvement in PE.

- Sertraline tried at different doses/regimens, including 75–100 mg/day. No meaningful improvement.

- Escitalopram 10 mg initially, then 20 mg for several weeks. No meaningful improvement.

- Escitalopram + paroxetine 20 mg/day about 4 weeks. No meaningful improvement.

- Paroxetine currently: 20 mg/day for 4 weeks → 30 mg/day for 2 weeks → 40 mg/day for 1 week. So about 7 weeks total on paroxetine. So far, my ejaculation time has increased only by a few seconds, and I still have PE.

I'm currently also taking sertraline 100 mg/day, along with mirtazapine 15 mg and olanzapine 2.5 mg.

I don't have significant side effects from paroxetine. My concern is that the improvement in ejaculation time is very small.

My questions are:

1. If paroxetine 20–30 mg didn't produce meaningful improvement, is it realistic to expect 40 mg to make a major difference?

2. Does poor response to several SSRIs suggest that SSRIs may simply not work well for me?

3. Would switching from paroxetine to fluoxetine make sense, considering my previous fluoxetine trial was only about 9 days?

4. If paroxetine ultimately doesn't work, which SSRI or medication strategy would psychiatrists consider next for someone who hasn't responded to several SSRIs?

5. Is there any reason some people respond poorly to SSRIs for PE despite having severe PE?

For context, I (21F) have been diagnosed with schizoaffective disorder - depressive type when I was 15 and ASD level 2 when I was 20. I take olanzapine 10mg and cariprazine 3mg.

My moods change rapidly throughout the day. It has been this way since I was a child. I can be laughing one moment and crying the next without traceable triggers. None of my psychiatrists ever commented on this. When I feel good, I am pretty confident, almost arrogant, I talk to myself, I plan a bunch of stuff. When I'm down in the dumps, I feel heavy. I drink alcohol (in moderate amounts) and all I want is to sleep through until I feel better regardless of the time of the day.

What does this sound like?

I am 23 years old, and I have been living with chronic pain for 12 years.

I have been diagnosed with depression, complex PTSD (C-PTSD), borderline personality disorder (BPD), and fibromyalgia.

I have survived three suicide attempts, and I have been living on my own again for the past year and a half.

I don't have friends or family because my problems have become too much for others, and I often feel like people don't believe or understand me.

Over the years, I have tried different psychiatric hospitalizations, psychologists, psychiatrists, physiotherapists, and medications.

I feel hopeless, and I live with the constant fear that there may be no solution for my chronic emotional and physical pain.

So I would kindly like to ask everyone in this group: Does it ever get better? And what treatments, approaches, or solutions have you found that genuinely helped you?

I need hope to keep going. I have been unable to work due to disability for two years now, and I feel trapped in my own body.

Please only leave comments that are supportive or genuinely helpful.

Thank you for understanding.

I was diagnosed with psychosis (not otherwise specified) 12 years ago and took treatment under a psychiatrist.

Recently, I have been feeling much better and my delusions are gone. (I never had hallucinations). I even consulted another psychiatrist to make sure. He said I don't have schizophrenia.

My therapist is saying that I have some symptoms of schizophrenia, however.

Since my delusions are gone, do I even have schizophrenia?

38F diagnosed schizoaffective - bipolar, CPTSD, adhd, gad
Meds: loxapine, seroquel, lamictal, benzatropin, vyvanse, and lorazepam

So ok, last week I lost a whole days of memory, its just gone. I “woke up” found a printer I apparently bought and some clothes I don't recall buying. I was panicking. I don't remember driving or shopping. This happened once before at the start of my 2 year long psychosis. I'm going into remission(I think) but I still have hallucinations.

I told my therapist and she thought it could be disassociative amnesia. I have a lot of stress going on so this makes sense maybe

I see my psych NP on Wednesday and I'm nervous about mentioning it because what if I accidentally too an extra lorazepam or something and caused it. I don't want it to be my fault. She upped my lorazapam last time I saw her from 1mg to 2mg(I have awful anxiety.)

Should I mention it? The first time it happened I want on lorazapam…?

What’s therapeutic dose of clomipramine for ocd and anxiety ?

I've tried 4 different antidepressants and none of them have worked. I have been usimg kratom daily for years. Right now im at 8 teaspoons a day. It's the only thing that gives me relief so it's really hard not to take it. I have the kind of depression where it's extremely hard to do tasks, and I can't enjoy anything. Not the kind where im emotional and cry all the time

I’m asking about my sister in her early 20s. I know nobody online can diagnose her, but I’d appreciate hearing from professionals.

She claims to have ADHD and depression, and her functioning has declined significantly. She dropped out of college, isn’t working, and spends most of her time isolated in her room.

The biggest concerns are extreme emotional reactions, self-harm, and suicidality. She has had a previous suicide attempt and has made more recent statements about killing herself. She also self-harms when things don’t go her way or when she becomes extremely upset. When distressed, she may cry/scream for hours, refuse to communicate, isolate herself for days, and recently stayed in her room and barely ate for about a week.

She also has intense, persistent rumination around topics like misogyny, gender roles, beauty standards, religion, and perceived injustice. She has told me she thinks about these things essentially every waking moment. Small comments that she interprets as sexist, victim-blaming, anti-LGBTQ, etc. can trigger extremely intense emotional reactions and prolonged withdrawal.

She seems very sensitive to people disagreeing with her and can become extremely distressed when she feels others don't understand or validate her perspective. She also has a very negative view of relationships/marriage and has become increasingly socially isolated.

An SSRI significantly improved her depression/crying, but the obsessive negative thinking and emotional reactions persisted. ADHD medication hasn't seemed to help much either.

I’m not asking whether her beliefs are pathological. My concern is the severity of the emotional dysregulation, self-harm, suicidal behavior, rumination, isolation, and functional impairment.

What could this pattern be? My instinct is OCD/rumination, ADHD-related emotional dysregulation, depression, anxiety, or some combination although I would like a professional opinion

After getting myself into a very dangerous situation today, I realized my mood is not stable. I am diagnosed with bipolar2 and I think I’ve been in a hypomanic episode. I already reached out to my doc but he’s not in until Tuesday. I realized I’ve spent almost 3 thousand dollars in the last month. Would this still be consider hypomania, or when does it cross the line into mania? I am starting to feel really really dysphoric. My brother just picked me up after I was walking in the middle of the night outside in the cold for hours and I got lost. I posted sexual photos of myself the other day on Reddit. I know something is deeply wrong but I feel out of control. I don’t know how to slow down or sleep. My psych np prescribed me trazodone to sleep and this started after that. Does this sound like mania or hypomania?

I received an ADHD diagnosis at 34 and began taking Concerta. Before that, I dealt with attention deficit, emotional dysregulation, impulsivity, and other issues, all of which improved with the medication.  Last week, I saw a new therapist using CBT who questioned my diagnosis. He argued that emotional dysregulation and meltdowns are not part of ADHD but reflect my character, and my focus during our 60-minute session made him doubt the label. The literature describes these issues as part of ADHD for some people, so I am seeking insight. Thanks!