Posted by Patient on July 25, 2003, at 15:34:59
In reply to Re: BPD patient on Lexapro carbamazepine » judy1, posted by Patient on February 17, 2003, at 12:28:00
It's been a while since I posted an update. I can say I haven't had a rage attack since writing this letter. I was taking the 5mg Lexapro and 200mg carbamazepine daily for a bit over a month, then I got so sick of being a zombie during the day that I quit both meds. I was fine for a few days until my husband mentioned my over-spending and I went downhill. I went back on the Lexapro, taking 5mg daily, and began taking carbamazepine on an as-needed basis, which is usually about a week or more before my period starts when I become more irritable. The carbamazepine does make me sleepy the next day, so the less I have to take it, the better if I don't want to be a zombie.
In the past two weeks I started taking 10mg of Lexapro in the early evening. So far, I am doing well. Ativan sits on the shelf most of the time. I think the situation at home has started getting to me with our rainy-day funds being used to pay health insurance, and our very low income not meeting our needs, and the job outlook for my engineer husband not going well (we think he's over-qualified). It puts pressure on me to find a job, but I just can't do it-I have too many fears and hang ups about working outside the home. He'll probably have to get a contract job which means I'll be by myself. This is what I want for he currently works at home, and it seems I can't get anything done with him around (retired couple syndrome? ;). I do much better by myself. My dad was the same way.
How true that antidepressants don't help a person get better, unless they are also getting good psychotherapy treatment. My affordable doctor just is not good at psychotherapy, and so I am not getting better as I would hope to. Instead of seeing him monthly, his ineffectiveness and our bugdet now allows for every 3 month appointments; could be pushing it to 6 mo. So, up to 10mg it is.
In the past I have fiddled with my dosage and gone off the medicines too often to prove to me that I do terrible without them. I think the anger is my worst problem. It's enough to keep me on these medicines for life. I would much rather suffer from panic attacks or severe depression, both of which I have suffered from, or accept the drug-induced apathy, than to have this temper problem that is like having a murderer live inside me. I was really hoping I would make the miraculous change like the patients in "Listening to Prozac", by Kramer.
I am thankful for the drug Lexapro, and for carbamazepine for when I do need to take it. Out of all that I've tried Lexapro is the one I'm staying with. I only wish I could have started on it in my teens, when all my problems started to show themselves. I can also understand why my brother with schizophrenia went off medicines so often-the side effects made him a walking tree.
This is my original post:
"Posted by Patient on February 15, 2003, at 15:52:30Hi,
I'm new here.
This past week my psychiatrist gave me samples of Lexapro and Carbatrol ER, also known as Tegretol XR(carbamazepine extended release).
Previously I was taking 20 mg Celexa daily for the past 4 months, augmented with 10 mg BuSpar (to help counteract sexual dysfunction as well as help boost Celexa), and .5 mg lorazepam (Ativan) taken during week prior to start of period (higher irritability time). I was doing so-so: feeling like a zombie during morning hours, then highly energetic by late afternoon/evening, which at times I would experience irritability. I began to take .5 mg Ativan at bedtime to help me sleep. Prior to this, I was awakening at 3-4 in the morning unable to fall back asleep. I think my worst complaint after first being put on Zoloft a couple of years ago for PMS, then switched to Prozac, and then Celexa, is apathy with each SSRI. This part of drug treatment is even worse for me than the drug-induced anorgasmia. I have not had the weight gain that others complain about. I do not like the lack of short-term memory, and having word-finding difficulties. It's enough to keep from from working outside the home for fear of screwing upsomething important (I would be working as vet tech).
As for what is wrong with me; my doctor hasn't outright diagnosed me as yet. I have been seeing him since 2001. He thinks I have Borderline Personality Disorder, or Bi-polar depression. I have suffered from bulimia nervosa for many years in the past. I have had big problems with spending too much money, impulsiveness, do not make long-lasting friendships, and do not work outside the home. Throughout my life I have suffered from depression and extreme anxiety with a very short temper. I also self-mutilate, but not in the strict sense of the word-i.e. I don't cut my wrists like I've heard some do for the adrenaline rush-I hit myself with my fists very hard, usually the forward sides of my head. I also hit my legs and stomach, but more so my head. This occurs during a rage attack and it's as if I wanted to beat myself up for I have so much hate towards me (must be what a spouse or child abuser feels when they are beating up on them). I have a very big problem with rage outbursts, as does my entire family. I cry and feel drained after hitting myself, and I no longer feel rage, but sleepy.
I am married but have no children (thank God, by choice), in my late 30's. This week I have started taking 5 mg. of escitalopram (Lexapro) in the morning, and 200 mg capsule of Carbatrol ER with evening meal. My doctor is hoping the carbamazepine (anticonvulsant) will help smooth out my ups and downs, as well as help with my anger problem. This is an off-label use for carbamazepine. My doctor ordered blood tests for platelets, white blood cell and red blood cell count prior to start of Carbatrol, since carbamazepine has been known to reduce white blood cell and platelets in some individuals. I requested a T3 and T4 thyroid test, as well as cholesterol test, since this drug can also affect these. My doctor did not request tests for liver enzymes. He mentioned he may later try lithium, but that's if carbamazepine helps.
So far I have noticed lethargy or sleepiness an hour after taking Lexapro (stronger than after taking 20 mg Celexa), but it only lasts for about 2 hours or so. When I first took Carbatrol, I noticed a bit of a druggy or spacy feeling, like one would experience after taking an antihistamine, but the next two days upon taking it I did not notice this as much.
I am happy to submit this information and will submit more as I go along with my current treatment. I am doing quite well, considering what I was experiencing just a month ago." next post was reply to judy.
poster:Patient
thread:200742
URL: http://www.dr-bob.org/babble/20030723/msgs/245246.html