Psycho-Babble Medication Thread 713000

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feeling worse with med changes

Posted by wishingstar on December 12, 2006, at 19:48:08

Recently I've started feeling more depressed than I have in several weeks, since I started lithium and got some relief from that. Suicidal feelings have also come back big time - from passive ideation back to the serious consideration I was at a month or so ago.

Currently I'm taking 300mg lithium - I was on 600 but started having panic attacks on this dose. Aside from some agitation, it seems to help a little.. but my diagnosis is unipolar depression, so it only helps to a degree.

I also recently started lamictal. I've been taking 25mg and will move up to 50 tomorrow, and up from there.

I also made one other change which may be the culprit. I had taken hormonal birth control for about 8 months and stopped it right around the time I started the lamictal... about 10 days ago. But everything I've heard about hbc is that is can cause depression, not the opposite, so it seems illogical that stopping that would drastically alter my mood in this way.

Do you all have any thoughts on this? Could it be the lamictal? Stopping the birth control?

I have one other fear. I am very resistant to medications and have been through tons with no success. But that was mostly while I was on the bc. Is it possible that stopping bc means we're no longer trying to medicate the same issue? I mean, stopping it obviously changes my body chemistry. Is it possible that some drugs that have not worked/worked over the past year now would have a different effect? I cant imagine having to re-try different anti-depressants, or having the lithium stop working on me now that my body chemistry has changed.

Thanks for your help.

 

Re: feeling worse with med changes

Posted by stargazer on December 12, 2006, at 23:20:15

In reply to feeling worse with med changes, posted by wishingstar on December 12, 2006, at 19:48:08

Here goes my lecture on med effects...if you are depressed and get more depressed on a medication for depression it is probably the med doing it to you, not the depression worsening. I saved my life with this theory once.

Any of these drugs can induce suicidal thoughts. Are you on just lithium and Lamictal? Any reason why no AD? Usually Lithium and Lamictal are added to other meds, like AD's, not used as monotherapy for depression. I know there are exceptions since I was on seroquel alone for awhile which did get me out of a very bad depression (may help you get out of this one so you can start something else once you're not so depressed and suicidal.)

I got worse on Cymbalta recently and also had a similiar effect from Zoloft years ago where the med was making me more suicidal to the point where I thought I might do something. Anyway, my pdoc and I have been collaborators for almost 20 years and he knows that I (not him) can only determine how a drug is working and if a drug makes me feel worse than I did before taking it, then we usually decide to stop it.

I too have tried most of the AD's and have not had a great deal of success with them. Just this year I was reaching a point where I had to do something different and currently I am on Emsam which has helped me alot. Have you tried MAO's, like Nardil or Parnate? Emsam is a MAO without the dietary restrictions and is a patch you wear.

Be careful with Lamictal as the dose increases (above 50 mg or so) since it made me very unstable in my balance and I had several falls, before realizing this was the cause (my pdoc missed it too).

Sorry for the rambling but I don't think the hormonal thing is a big issue, it seems the choice of meds is not the right one. If I were you and you haven't tried a MAO, that may be the next best thing to try.

Stargazer

 

Re: feeling worse with med changes » stargazer

Posted by wishingstar on December 13, 2006, at 9:18:59

In reply to Re: feeling worse with med changes, posted by stargazer on December 12, 2006, at 23:20:15

Thank you for your detailed response. I was mostly convinced it was the birth control and I had done this to myself by fooling with it, not my psych drugs.

Yes, you were correct - I am only on lithium and lamictal at this point. As for why... I think my psychiatrist just didnt know what else to try. In the last few years, I have tried lots of drugs.. lets see.. zoloft, prozac, wellbutrin (twice), effexor, celexa, and lexapro.. and none have had any effect at all, even at high doses. I have never been on an MAO drug. We did discuss emsam (is that right), the patch, but I'm told it's very expensive and my health insurance may or may not cover it.. theyre very finicky with these things.

I actually did get a little relief from lithium, especially at 600mgs. I had passing moments where I felt better than I remember feeling in a long time. But the tradeoff was that I also had incredible anxiety and the first panic attacks of my life, and was very irritable. 300 seems to help a little, although by now I'm sort of unsure where the baseline would truly be without medication. It's possible it isnt helping. I definitely dont feel great. I think when lithium helped though, that is what led my doctor to add lamictal. Originally he had talked about using lithium only to augment an AD, as you mentioned, but since we havent found an AD that works, here we are.

I started the 50mg lamictal last night. I'm going to watch myself carefully and if I seem to take a dive even further into depression, I will call my doctor. My next appointment isnt until Jan 4. Thanks for the headsup on the balance issue - I am a very petite person (around 100lbs) so these doses can get pretty heavy for me sometimes.

Thanks for all your suggestions.

 

Re: feeling worse with med changes

Posted by stargazer on December 13, 2006, at 9:59:32

In reply to Re: feeling worse with med changes » stargazer, posted by wishingstar on December 13, 2006, at 9:18:59

Emsam is expensive but so far I have gotten samples from my pdoc. Once I have to get it myself I may have problems.

Nardil is cheap but there are the dietary restrictions but when it works it can be very effective for TRD, which most of us here have.
I used Nardil years ago and it really worked very well. My pdoc thought we should try Emsam first since it doesn't have the food restrictions and it is 'NEW' and easier med to use. The cost is outrageous. If my insurance doesn't cover it I may fight them on it since it is less risky than the older MAO's.

I tried all of the meds you were on...got some benefit with Celexa plus Wellbutrin together. Have you tried combos like this? I also tried Geodon, Cymbalta, and a few others I can't remember. Did you ever try the tricyclics, which are in a different class altogether, many people here would say you should try one of those first. Your pdoc should be able to advise on those and on MAO's. If pdoc is not familiar with using MAO's, that would be unfortunate since they can work very well and the dietary restrictions aren't that big a deal. I didn't find them to be since the tradeoff is so great.

My feeling is you have to try something other than the SSRI type meds you have tried, ones that affects norepinephrine (NE) or dopamine (DA). I don't have a good understanding of how each med affects which neurotransmittors but others here do and your pdoc can advise.

Hope you find the answer soon.

SG

 

Re: feeling worse with med changes

Posted by wishingstar on December 13, 2006, at 11:08:55

In reply to Re: feeling worse with med changes, posted by stargazer on December 13, 2006, at 9:59:32

The only combination I have taken so far was wellbutrin and effexor together several years ago, with no effect aside from some stomach problems which still linger from time to time. I didnt tolerate celexa well, and wellbutrin gave me very odd side effects the second time around so I wasnt on it too long. All the others I have taken for several months though.

I havent ever been on any of the tricyclics either. Next time I see my doctor I may mention this. I took my first dose of 50mg lamictal last night and woke up this morning feeling absolutely terrible (depression), but that happens time to time without meds so I'm waiting to see. The diet restrictions of the MAOs would be no problem at all if the drug actually worked for me.

Thanks again for all your help.

 

above for stargazer (nm)

Posted by wishingstar on December 13, 2006, at 11:09:32

In reply to Re: feeling worse with med changes, posted by wishingstar on December 13, 2006, at 11:08:55

 

Re: feeling worse with med changes

Posted by blueberry1 on December 13, 2006, at 18:55:28

In reply to feeling worse with med changes, posted by wishingstar on December 12, 2006, at 19:48:08

No way to no for sure except to stop it and see, but it sounds like lamictal to me.


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