Posted by Laurie1041 on May 27, 2011, at 7:28:05
Hi I have been posting/viewing this site on and off since 2000. I have a problem and could use some recommendations.
Quick review: I have been on SSRI's and Klonopin since 2000 for now what seems situational depression and Effexor induced nocturnal panic attacks. Never being able to get off Effexor due to withdrawals and still somewhat mood depressed (believe me, I now know what depression is and isn't) I tried low-dose Lithium, little to no effect, Wellbutrin, too much anxiety.
In 2007, went on Provigil for Shift Work Sleep Disorder due to switching to night shift and sleep/wakefullness problems. I became fairly hypomanic to manic and overspent using credit cards. Got depressed naturally when bills came in and I could not pay. This was when I was diagnosed with BP I. My doctors and I never considered the fact that Provigil could have triggered a switch to mania. Once I got labeled BP I and I had mounting money pressures, depression/anxiety, the meds started to spiral.
2009-My husband had just died at the end of 2008. I was grieving, severely depressed (naturally), had zero support. My sister was waiting for me to "fall apart" and evidently had a "emergency plan" in place. She took me to UCLA ED and said I had overdosed on Lithium. I had in fact inadvertently taken a single extra dose by mistake. Welcome to my nightmare! 5150'd and discharged on more meds including Wellbutrin which made me so anxious and I of course was still grieving and depressed that I went back to the hospital within 2 weeks. This is when I was started on Adderrall for depression, along with SNRI. I quickly felt really great, no longer felt sad about the death of my husband (?) and went through my insurance money at alarming rate and engaged in tattooing at age 49 (?). My family was aghast. I thought they had a problem.
Felt so good I went back to work at end of 2009 and since I had been out of work for 2 years, I had difficulty with stress/pace, and was asked to resign. Naturally very, very depressed. Several hospitalizations in 2010 more med changes, more EPS, etc.March/April 2011- Had been informed back in 2009 by pdoc that he had me "squeezed" with the use of a stimulant and SNRI, but I really had no idea what he meant. In March 2011, I told my pdoc, I wanted off of Adderral and to begin titrating down my Klonopin and SNRI. He takes me off Adderral, gives me Nuvigil. Nuvigil makes me feel anxious, plus my Klonopin has been reduced (hindsight). See pdoc on April 5, 2011 and I am depressed, anxious. Had no idea I was in withdrawals from both Adderral and Klonopin and he reinstates Adderral and goes back to original dose of Klonopin. Within 2 days, exactly, I become convinced that my meds are actually making me very, very ill instead of better and that I am on a huge rollercoaster. I begin to be depressed and rageful, argumentative and then rational again several times a day, expressing to my family, "It's my meds!". After seeing 3 pdocs in consultation with my family, the last pdoc, takes a look at my entire "psych" history and list of meds tried and failed and says, "You are screwed, I won't take your case because I never wrote for these meds, but I will call your pdoc and give him my advice as to get you off the Adderrall first before attempting anything with the Klonopin. In fact, Klonopin is the least of your med problems". I was completely rational and not mood cycling at this time.
4/21/11- I voluntarily admit myself because I cannot stop the never-ending cycle of anger, hopelessness, crying, return to rational planning to get my meds under control and become suicidal. My pdoc says, "You are very sick, a very, very ill woman" and d/c's Adderrall, drops Pristiq from 100 mg. to 50 mg. (that's a 50% taper!), d/c's Lithium and adds Depakote. Within 4 days of discharge I am going through hideous SNRI withdrawals, both physically and emotionally and my pdoc says to break Pristiq time-release formulation tablet in quarters. I had tried this at home and got violently ill and told him so. He said that I needed to cross over to an SSRI that came in a crushable tab or liquid prep for easier tapering and added 10 mg. of Lexapro to the Pristiq. Voila! All withdrawal symtoms went away. I was happy, briefly.
5/25/11 started feeling mood unstable on Depakote 1500 mg. Pristiq 50 mg. + Lexapro 10 mg. and he said increase Lexapro to 20 mg. and we will get you off Pristiq asap.
Within 2 doses of Lexapro 20 mg. + Pristiq 50 mg. I am feeling the rageful,angry, hopelessness, I am in way over my head with these meds feelings again. My family is terrified and told me to go to the hospital. I go. I start filling out the paperwork and get so angry. This will be my 8th admission which consist 90% of med-related problems (EPS on atypicals, severe anxiety Wellbutrin on not 1, but 2 occasions). I ask my mom to take me home and I call my pdoc and I tell him (not in my usual passive self) very firmly that I can no longer scare the hell out of not only myself, but my family. He said, "I am sorry, you are between a rock and a hard place. I want you to use Zyprexa 5 mg. as a 'rescue med' when you get very agitated and when you are more stable we will d/c the Pristiq so we can begin to slowly taper you off Lexapro".
I feel my pdoc placed me at risk by putting me on stimulants and not tapering me off of SSRI's when clearly none of them were working anyway and the last time I checked there are no medications that work for grief and grieving. He has me chasing medication after medicaiton. I do not have another treating pdoc at this time, he always returns my calls within 3 to 5 minutes, but I think I need to change treating approaches, but am frightened because at least this is "the devil I know". My sister says not to panic because rushing to get another pdoc is not going to save the situation because there are no quick fixes to tapering off of SSRI's. It has to be done slowly and systematically which I agree.
I now have a Rx for Zyprexa 5 mg. that I can take either twice a day as needed for agitation or up to a total of 20 mg. daily until such time as my mood becomes stable as I d/c the Prestiq, wait for withdrawals to occur, increase Lexapro if necessary, become mood unstable, then start tapering Lexapro down by up to 10% every 3 weeks or as tolerated.
If you have even made it this far, I feel so very blessed. Thank you. I have an appt. with a UCLA Internist on June 9 so that I can get a referral to a pdoc at the Mood Disorders Clinic for Women. I have no idea how long this will take me to get an appointment.
I am scared. I have gone from a grieving woman over the loss of her husband to a "very, sick, very ill woman". I am angry at my pdoc for what I perceive as endangering my life with giving me medications that make me very mood unstable. My family is at a complete and total loss and are not medically astute people. I am the RN in the family and they have always looked to me for sound recommendations.
What can I do? What are my options? I know this sounds really crazy, but I have known my pdoc since 2009 and even though I feel he has made errors along the way, I feel that he does care and he is responsive. Thank you very, very much for any and all help and suggestions. Laurie
poster:Laurie1041
thread:986332
URL: http://www.dr-bob.org/babble/newbs/20110115/msgs/986332.html