For the record, I suffer from inattentive ADHD, severe OCD (onset at 19) and depression (onset 23 -- 3 years ago). Granted, things have always been difficult, firstly due to the ADHD, then the OCD. But after depression, I just haven't been able to recover cognitively. As I'm gifted and was at least functioning at quite a high level prior to depression, I just find that living like this for the past 3 years is just taking more and more of a toll on my motivation and desire to live. As I say, my OCD is severe, but I don't feel like that should deny me the ability to do things I'd like to do; I've struggled with therapy -- mostly due to the aforementioned motivation issues -- and am about to see a new therapist, but I think if I could improve my functioning, I'd have more motivation to engage with therapy. For the record, one (silly) therapist thought I had catatonic schizophrenia, but I had cognitive testing done as a result; I was trialing low-dose clomipramine at the time and scored in top the 5% of the population (I assume the strong NRI metabolite helped), but I found clomipramine too anxiolytic to continue with.
I'm highly sensitive to medication. For the ADHD, I've tried Ritalin LA, but it overstimulated me (didn't know I was so sensitive at that point), then immigrated. New psychiatrist put me straight on Dexamphetamine, which worked erratically -- if I was stressed, it could put me to sleep, other times it worked well, but exacerbated my OCD; combining it with a high-ish dose SSRI (20mg Lexapro) deleted most of the positive effects. Strattera overstimulated me (psych didn't know I was sensitive at that point and point me straight on high dose), and also made me really dysphoric.
I've found Nicotine gum and lozenges to be the best nootropic (I was able to read books again for the first time in ages after I tried it), but for some reason it just gives me brain fog these days.
Right now, I'm on Parnate (60mg). This is the max my psychiatrist will prescribe. It's only been a week and a half at this dose, so I need to hold out at least 2 more weeks before I make a judgement. So far, it's brought my depression up to mild and helped anxiety, but not done much for cognition.. in fact, I tend to feel spacey but am told that should improve; I also take 1mg of Klonopin for sleep, which I think also affects my cognition during the day.
Vitamin D (400IU) - anymore causes anxiety
1 cap Mag + Potassium Taurate (not sure dose)
1g Perilla Oil
High-dose Vitamin A (twice a week)
1g Perilla Oil
Trying to experiment with Zinc, but it seems to cause anxiety. Also have some Li Orotate, but waiting to see what Parnate does first.
Anyway, I have to be on some kind of AD .. that's obvious. Without one, I suffer from leaden paralysis and have trouble moving, exercising, etc. Even low-dose Lexapro (5mg) alleviated those symptoms, however, but left me quite flat and anhedonic.
Unfortunately, due to the OCD, I'm just not sure if I can take things like Piracetam, cholinergics, etc. I've been looking into Ach-inhibitors like Huperzine A and Aricept with some interest, possibly as an add-on to Parnate or whatever other AD I go on should it fail (not that there's many left that I haven't tried), but again, I don't know how these might affect OCD. I'd like to try Memantine .. I'd be curious what it does in combination with an MAOI. Otherwise, if all else fails, there's the Memantine + stim combination, I guess.
I just desperately need some prefrontal activation. On SSRIs alone, or depressed, I'm disorganized, my reading comprehension falls apart, I have no mental control or attention span (can't even meditate). When I am decently stimulated -- like the doses of Dex which affected my OCD -- I can at least function, meditate, control how I approach intrusive thoughts by shifting my attention span etc. Unfortunately, I think stimulants alone just burn me out (hence the tiredness, and possibly why even Nicotine doesn't work very well anymore), but I would glad take trade some anxiety for improved functioning.
Anyway, thanks for reading all this.