Posted by schleprock on November 26, 2012, at 20:55:11
In reply to all these decisions to make..., posted by hansi555 on November 26, 2012, at 9:40:25
> The last couple of days have been somewhat better, but I am still very energyless and tired. I have agreed with my workplace not to work the next couple of weeks or more, I am simply too tired and down to do it.
> Anxiety has never been a real issue to me and I really dont feel it is right now (but this Saturday I was really way down and scared a lot about it).
> I am still confused but also thankfull by all the answers I have received on this thread. I cannot tell if Lithium is the right step to take next as I am a bit worried about the SE and comments from schleprock.
>
> I have decided to ramp up the Mirtazapin from 5 to 15 mg and maybe face out the Valdoxan completely (I think there are too many drugs in this cocktail), I could also maybe go higher on the Nortrptyline than the current 120 mg as I know I am in the low side of the therapeutic window.
>
> I am still very puzzled about what triggered this whole thing this time. Was it really just the Abilify test or is my level of activities (work, family, hobbies) just too much? I did not feel stressed, it just came sneaking from behind
>
> I am going to my pdoc in 2 days time...hansi555, was there any recent change in your level of activities? Is it reasonable to think that family or hobbies could make you this way? You just said that you did not feel stressed, while stress played a role in your original condition. You implied that this drop in your condition came out of nowhere. The only significant difference in your lifestyle was an Abilify trial, in which there was a period you felt worse when on the drug.
From your last post it seems like you were able to work out all the implications from the above facts. I feel very sorry that the rest of the people on this forum are having trouble with this (whith, and I never thought I'd be supporting him, the exception of Lou Pilder), especially taking into account the aspects of confusion that a heavy depressive state can bring. It is essential that you mention to your pdoc that you are worse off than before you started Abilify, and want to work on returning yourself to your prior state. I think it is a wise choice to start by increasing the dosages of the medications that were already helping you, just make sure that you are not surpassing the maximum suggested dosages. Certainly raise the nortriptyline to 150 mg; I do not know who suggested 120 mgs to you, it just doesn't make any sense when 50 mg tablets are readily available, and that 150 should be considered the typical dose if it is your primary antidepressent. This action should have been taken when it was discovered that you were at the "low end"; I doubt 30mg will push you out of the window, and could be very beneficial if you have a high sensitivity to medication, which you might have. I'd also question your doctor's suggestion of Lithium. Make him go into explicit detail about how this medication will "help" you, and be sure to remind him that you are not bi-polar.
poster:schleprock
thread:1031808
URL: http://www.dr-bob.org/babble/20121113/msgs/1031985.html