Psych Meds: Dancing With My Pink & Whites

I’ve discovered the correct med combo for my BP II.  That in itself is in comparison to winning the lottery.  I at long last won the med lottery with my pink (Lithium) and white (Lamictal) combo.  It only took eight years, but I really am “Dancing with my Pink and Whites”.

Actually, I have the main 2 meds w/Zyprexa & Seroquel added.  The last two I really use for sleep, although Zyprexa & Seroquel are used for BP.

The meds though, it’s amazing how sensitive your body is to them.  The med Zyprexa, that I am on, I gained 40 pounds outright.  I fought to get off of this med, but it made up the final combo 4 and is successful for me.  I did drop from 15mg to 2.5 and also some girth around the mid section dropped some too, so I was content with that.

But, what’s with the pdocs and the meds over the years?  They never gave the meds a chance to work.  I recall so often, I’d be on one med for a month, then completely taken off, then 6-8 months down the road put on this same med again, then yanked off it once more.  Are these the quality decisions we want from pdocs?  Were they even looking at my charts? The other meds were just not working; couldn’t they see that?  Obviously not; the snowball effect: ECT, hospitalization, suicide attempts, all due to drug-resistant depression.  A circle of sorts.

Hospitalization became the norm in my life, so this was the typical agenda:

My anticipated three-week wait, post-discharge from hospital for my outpatient appointment finally arrives.  Pdoc greets me, smiles, goes over my medications, asks how I’ve been (I feel as I have to talk in rapid speed due to appointment time limits), I tell him I have been lousy, he says “we’ll increase this and that”, shoves a script at me and states “and I’ll see you in a month”.  And that was it.  One month.  I waited three weeks for a 6.5 minute visit and a crappy script.

I always wonder too, why do they always seem to increase?  At least they seem to with me – tiny doses of course each time.   And never time for true assessments.  A major beef of mine are the changes in meds.  I may have 75 pills left over from the last prescription.  Very expensive.

I was never without all of the side effects: puking, weight gain/loss, nausea, hand trembling, zombie state and actual depression.

Here are just some of the psychiatric meds.   I was not on all of these listed, but quite a few sure ring a bell during my eight year journey:

Selective serotonin reuptake inhibitors (SSRIs). Doctors often consider selective serotonin reuptake inhibitors, such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro), as the first-line treatment for depression because they have fewer serious side effects. They seem to work by increasing the availability of the neurotransmitter serotonin in your brain. Drugs similar to SSRIs include serotonin and norepinephrine reuptake inhibitors (SNRIs), such as trazodone (Desyrel, Trialodine) and venlafaxine (Effexor), and dopamine reuptake inhibitors, such as bupropion (Wellbutrin).

Tricyclic and tetracyclic antidepressants. These medications also affect neurotransmitters, but by a different mechanism than that of SSRIs. They may be used for any type of depression, be it mild or severe. Among tricyclic antidepressants are amitriptyline, desipramine (Norpramin), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), trimipramine (Surmontil), and a combination of perphenazine and amitriptyline. Tetracyclics include maprotiline and mirtazapine (Remeron).

Monoamine oxidase inhibitors (MAOIs). These drugs, which include phenelzine (Nardil) and tranylcypromine (Parnate), prevent the breakdown of neurotransmitters. The drugs have potentially serious side effects if combined with certain other medications or food products. Doctors rarely use them unless other options have failed. Your doctor may prescribe them if you have chronic depression and eat or sleep excessively.

Lithium and mood-stabilizing medications. Doctors prescribe lithium (Eskalith, Lithobid), valproic acid (Depakene), divalproex (Depakote) and carbamazepine (Tegretol, Carbatrol) to treat bipolar depression. Medications called atypical antipsychotics such as olanzapine (Zyprexa), risperidone (Risperdal) and quetiapine (Seroquel) were initially developed for treatment of psychotic disorders. Doctors sometimes also use them to treat bipolar disorder.

So many people criticize Lithium, however dramatic, it pretty much saved my life.  I am very fortunate to have few side effects from it, and moods are pretty stable. 

The only close call I did have with Lithium was, and truly my own fault:  I went to an open market in the summer, no hat on, no bottle of water, ate no breakfast and stood out in the hot sun for 2-3 hours.  Came home, started feeling nauseous (flu symptoms), headed to bed, sudden cramps, diarreah and then suddenly I fainted.  I was staying with a friend and she got me to ER.  Turns out I was severely dehydrated, had to be hospitalized for 3 days on IV and doctors said I would have needed dialysis if I had waited.  A close call.  I was shocked and stunned!

But thanks to my present psychiatrist, who out of all of those other pdocs knew what the hell he was doing, and put me on the correct meds, I can at least enjoy my life now.

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10 thoughts on “Psych Meds: Dancing With My Pink & Whites

  1. Isn’t it amazing though! Such wasted years, and such wasted meds. Finally finding the right doc/meds is crucial for our illnesses. For me, without that, I would still be ping-ponging between home and hospital.

  2. I’m glad you found what works and that you have a good pdoc. After 12 horrible years I found a great pdoc at long last and was finally put on the right medications! Yay for me! :) I have schizophrenia. Anyway, I’m on Haldol, Geodon, Zoloft and Buspar and have been well for about 7 years now (knock on wood). It is amazing what the RIGHT meds can do! Enjoyed your post. :)

  3. Yes, I am still on Zyprexa, reluctantly, mostly for the weight gain. I remain on it due to the fact that the combo 4 (lithium/lamictal/seroquel/zyprexa) have been my life saver for 3-4 years now. My pdoc knows what he is talking about, and set aside extra pounds for mixed states and black depression.

    As far as the levels checked, no, only levels checked for lithium – once per month. These are cruicial due to kidneys.

    Never heard of Zyprexa test, possibly due to a higher dose – I am on a small dosage 2.5 mg. Good luck and take care.

  4. hey Cherished i wasnt clear to me on if you still use Zyprexa, i use to take it. And it was very helpful in contolling my rapid cycling. When on Zyprexa it is reall y important to have glucose/sugar levels checked reularly. Zyprexa had a nasty association with diabetes today.

  5. Wow, the list goes on. I had so many pill vials of pills here and there. When they took me off of various cocktails of meds, I’d have sometimes 75 pills left, other times 125 pills leftover X 4 or 5 vials etc. What to do with all of these pills and money wasted. So I’d trot off to the pharmacy for disposal. Easy for the docs, they just issue the scripts.

    The world of the internet is invaluable for so many things, and for that I mean the intricacies in the world of my medications. I can investigate the side effects etc., and any questions can be presented to my pdoc during the next visit.

    Hope you and your Dad have as good luck on Lithium as I have.

  6. Glad you have your meds sorted, finally.

    I was treated for straight depression till a year ago when I got a bi-polar approach instead at last.

    Now I’m on duloxetine, a fairly new anti-depressant. So recent they can’t really tell me what happens when you’re on it long-term. But I know that when they tested it on rats, they got liver cancer. One wonders why they test things on animals, if the drug still goes to market after that!

    I’ve been taking Milk Thistle whilst on it, as that’s meant to help your liver. Other than that, no alcohol, and fingers crossed.

    I know liver disease is terrible, and a nightmare way to go, but I’ll take the risk for a bit of brain relief.

    Then also I have stelazine, for if I start climbing. I don’t have anything for if I start sinking. So far the duloxetine has stopped me going too low.
    Hey ho!

    Recognise lots of the ones on your list.
    Effexor- great, but had to come off it cos it made my pulse race.
    Citalopram- huge weight gain and stomach cramps.
    Prozac- worked for a while, then caused rage, anger, high blood pressure. Cost me a job.
    Sertraline- hot flushes so bad that my post-menopausal mother thought it was hilarious.
    Paroxetine- dry mouth, dizziness, insomnia.
    MAOIs- I had a reversible MAOI, or RIMA, not legal in the USA. Made me very angry and short tempered and tearful. Still, they left me on it for 10 months.

    And more….

    They have offered me risperdol but I refused. No more weight gain, please. Still have the excess to lose.
    Dad’s on lithium. They said I can have it if I feel I need it some time….

  7. I, too, now have a psychiatrist working with ME and my illness with the correct meds. It is such a relief, and although the expense is there also – this is my life we are dealing with. I am so very fortunate to have a benefit plan at work, however, it wasn’t always this way and we were in the red for many years with stupidly prescribed medication costs alone.

    So very happy you are doing well, and with a good pdoc – but do have to fight for the med costs.

  8. David: Scared the crap out of me; actually the whole hospitalization scared me. But as stated, it was my own fault, as pdoc always said to drink plenty and stay out of the sun. You know the old – yeah, yeah. Hope I can prevent anyone else from being this foolish/stupid/careless.

    Never realized how Lithium affects the kidneys.

  9. I am fortunate to have a Psychiatrist who works with my medicine and is my therapy. Its amazing what a difference this makes – but its rare and hard to find. She knows me very well and can see things quickly and respond with words or meds appropriately.

    Therefore, I pay out of pocket and have to fight the insurance company for even a teeny bit of coverage.

    Overall? Worth it!

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