Hello @barnowl53, @karen00! I am a volunteer mentor on Connect and wanted to mention something I have recently done with my psychiatrist. I had a DNA/gene analysis from a few cheek swab cells. I don't fully understand the results, but they helped my psych get me on the medicine that I should respond to better than other antipsychotics. I have chronic pancreatitis and besides pancreatic insufficiency, I primarily suffer debilitating pain and only opiates even take the edge off. I have been on synthetic morphine - extended-release and breakthrough - for over a dozen years now. I had generalized anxiety disorder and after a few years of the pain and opioids was dx'ed with severe depressive disorder. I have been through extremely dark periods and more moderate periods. I have never gotten any great degree of relief from the many antipsychotics I have tried, but armed with the information from the gene analysis, I am now on Nuvigil and Prestiq, along with Remeron for sleep. We also learned that I have a MHTFR mutation which causes one to not produce an enzyme needed for serotonin production/absorption. For that, I take an over the counter supplement called L-Methylfolate. The body should convert folic acid or folate into this substance and that enhances my body's use of serotonin. One other thing revealed was that I am a very fast metabolizer of medicines which means I need higher doses to be therapeutic. The past 4-5 months have been very difficult physically and would have typically put me in a downward spiral to deep depression, but so far, it has not. I am getting a bit frustrated with the situation, but not terribly depressed.

I wish you relief from this horrible disease,
Gary