This is a story about self prescribing...

If you know what medication you want, you can cut out the middlemen and just buy it yourself direct from a country that doesn't have a rigid system of prescriptions, provided it's not a controlled substance, and therefore illegal to import.

I wrote about self medication through non-pharmacological mechanisms in a previous blog post entitled Self Medication (Part One) if you wish to refresh your memory.

Going GP -> Psychiatrist -> Pharmacist is actually quite a slow process when you're trying to find a medication that works for you. Also, many medications are only licensed to treat certain illnesses, but there is sometimes a strong body of research that proves they are effective on other illnesses. Because of concerns about medical malpractice lawsuits, it's quite hard to get an 'off label' prescription, even if there is good data to support the use of a particular medication in your individual case.

So it was that I came to be experimenting with medications like Pramipexole (Mirapex), Bupropion (Wellbutrin), Cabergoline (Dostinex), Aripiprazole (Abilify) and even crazy ones like Piribedil (Trivastal). Results were a mixed bag.

The bottom line is this: you probably don't want to f**k with medication. Aripiprazole left me uncontrollably dribbling, and unable to speak without an unintended spray of saliva. Piribedil would cause me to fall asleep randomly, like a narcoleptic.

But, Bupropion works. It's a very effective, fast-acting antidepressant. However, it raises your anxiety levels, causes insomnia, panic attacks and exacerbates hypomania. It's not a good medication for somebody with Bipolar, unopposed by a mood stabiliser.

Messing around with medications was very dangerous, and I may have even put myself at risk of early-onset Parkinson's disease. Certainly, my later messing around with L-DOPA was on a trajectory leading to complete disaster.

It's about harm reduction though. Tea and coffee are on a stimulant continuum that leads to amphetamines and even stronger stimulants. Alcohol is on a depressant continuum that leads to benzodiazepines and even stronger 'downers'. If you have been using coffee & alcohol to self-medicate for your mood fluctuations, you will be driven to seek out stronger alternatives, when those substances no longer work anymore, or face a breakdown.

Eventually, you'll find that heroin is really great to help you sleep, and crystal meth is really great when you need to be awake and get stuff done. You don't want to end up there. Don't go there.

There are modern sleep aids like Zopiclone & Zolpidem, and newer wakefulness and concentration promoting agents like Methylphenidate (Ritalin) and Modafinil. Naturally, I experimented with these.

Ritalin, I found to be very much like cocaine. You want to take more but you're not sure why. You don't really feel like you're getting anything out of it, but you strangely find yourself taking loads of it. Dangerous. Elizabeth Wurtzel wrote a book called More, Now, Again which is amongst the literature that inspires my writing. However, it's simply not possible to snort 60 Ritalin pills, like she claims. That volume of powder will simply not fit into your nasal sinuses. She's right about one thing though: Ritalin is addictive.

Modafinil simply makes you awake, not happy. More time awake, unhappy, is really the very last thing that you want if you're depressed, so I discontinued its use and find no function for this wakefulness promoting agent, personally.

Zolpidem doesn't keep you asleep for long enough to be of any use. Sure, you fall asleep, but then you wake up again and spend the whole night with your usual insomnia. Useless.

Zopiclone works but it's a little too brilliant. Again, for somebody with Bipolar, waking up feeling totally refreshed simply stokes your hypomania to dangerous levels. It delays an inevitable crash, when the drug ceases to be effective at acceptable dosages, and insomnia leads to exhaustion, which leads to depression.

It's all available, out there on both the public internet and the Dark Web. It's a few clicks away for a middle class person with a computer and a postal address.

My parting advice is this: don't go there. Don't even look. Don't tempt yourself. Don't give yourself false hope. Don't experiment. I've done the experiments, and found nothing good there. The side effects just aren't worth it. The downsides outweigh the upsides.

There are no medicinal cures. There are no medications that 'fix' Unipolar Depression and Bipolar. It's an avenue not worth pursuing.

Sorry about that.

Tags: #bipolar #depression #mentalhealth