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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Treatment For Dysthmia, Panic Disorder, ADHD?

I ve been diagnosed with multiple things. Dysthmia, Panic Disorder, ADHD and Borderline Personality Disorder. I think ADHD, and BPD are primary. I probably actually have both. Through great research I decided I wanted to try Abilify, and I asked a Medical Practitioner, and it works very well with certain symptoms. Especially it stops me from losing emotional control and having stress induced emotional outbursts where overwhelming surges of emotion (easily triggered) overpower my better reasoning. For this it is 100% effective, incredible. Literally I have been on it for a year now and not lost emotional control a single time. Part experimenting, part by flook (ie luck) I discovered that 400mg per day of Modafinil significantly augments the effects of the Abilify. I do not only not lose emotional control now, but I don t feel overwhelmed by stress and negative emotions in the first place. I feel well, positive and able to cope with life. For the first time I am also motivated, and my concentration has improved quiet dramatically. I have had various tests, and know that physically I am in good health (blood tests all fine etc). But I am not sure what to say to a doctor, that basically through experimentation (without informed medical supervision) I have stumbled across a miraculous combination of medications. Literally like I am basically cured of my problems on this combination. I have spend decades of my life FAILING to find such a combination, and finally I have it. I have been on Disability for these problems for 1.5 decades, now I believe I am fit enough mentally to consider working. As I have been keeping my Modafinil use a secret- what should I do? Its not an approved indication for it. My belief is both the Abilify and Modafinil are likely improving the functioning of various areas (especially the medial area) in my prefrontal cortex. Abilify modifies various serotonin receptor types in the PFC and Modafinil, apparently increases Dopamine, Noradrenalin, and indirectly Serotonin in the PFC. Basically they are both PFC enhancing medications (if you read the latest literature and research). I don t know how to explain it to him, but it was from reading THOUSANDS of pages of scientific literature that I suspected my problems likely occur due to Prefrontal Cortex under-activity , especially Medial and perhaps orbit-frontal areas in regards to the emotional and stress intolerance aspects of my problems Any advice you can offer would be appreciated.
Mon, 7 Apr 2014
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Psychiatrist 's  Response
Hi
Thanks for using healthcare magic

You are right behind your logic that your problem is related to prefrontal cortex and you need medication that could maintain the balance between serotonin and dopamine. In that, you can use an antidepressant like paroxetine or stimulant like modafinil which would increase the level of dopamine at frontal cortex. Abilify consists of aripiprazole and it is a partial agonist of dopomine. You can take it in low dose with modafinil and antidepressant.

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Treatment For Dysthmia, Panic Disorder, ADHD?

Hi Thanks for using healthcare magic You are right behind your logic that your problem is related to prefrontal cortex and you need medication that could maintain the balance between serotonin and dopamine. In that, you can use an antidepressant like paroxetine or stimulant like modafinil which would increase the level of dopamine at frontal cortex. Abilify consists of aripiprazole and it is a partial agonist of dopomine. You can take it in low dose with modafinil and antidepressant. Thanks