The long journey of medications

Hi all!
There was a thread started by someone in the BP forum about BP meds and the trials and errors with those. I thought I would start a thread here, beginning with a cut/paste of what I posted in the BP forum so that loved ones of cyclothymics could get a glimpse of what a medicinal journey looks like, and my fellow cyclo's could post their own medicinal journeys to share what's worked and not worked for each of you.

Loved ones: as you read my listing, keep in mind that my list of medications are from my entire adulthood... about 25 years of age and onward. My list is relatively short compared to others' postings I have read, especially those with multiple diagnoses. Take particular note at my list of anti-depressants. It includes most of the major AD's out there. AD's require time and dosage increases to get into your system... so for each AD you see, it entailed about 2 months to a year EACH of my life. So this medicinal journey spans a lot of time. This is why the search for the proper med combination is soooooo frustrating. We spend a couple of months on a med to find it either doesn't work or has intolerable side-effects, so we move on. After strings of failures, it's hard to keep giving new meds a try, since you know each new med involves a minimum of (in my case) 2 months of your life and may or may not work. This is why our journey through trying meds is fraught with frustration and, at times, we throw up our hands, throw out the pills and give up for a while... only to pick the battle up again when life gets too unmanageable down the road. I hope it is helpful to see my list.

Fellow Cyclo's- what meds have you taken? side-effects? current meds? what worked? didn't work? Share your journey if you have the time to write... it'll be of interest to me and others, I'm sure

============================

KOSHKA'S MEDICATION JOURNEY:

Anticonvulsants:
Oxcarbazapine (Trileptal)- 600mg, no negative side-effects thus far

Antipsychotics:
Risperidone (Risperdal)- 4mg, massive weight gain, blurred vision, shaking hands (slight)
Quetiapine (Seroquel)- 50-100mg as needed, no negative side-effects thus far

Antidepressants:
Fluoxetine (Prozac)- 40mg, no negative side-effects thus far
Bupropion (Wellbutrin)- (forgot dose) anxiety, weight loss, insomnia
Sertraline Hydrochloride (Zoloft)- (forgot dose) massive weight gain, triglycerides thru roof
Citalopram (Celexa)- (forgot dose) massive weight gain, triglycerides thru roof
Paroxetine (Paxil)- (forgot dose) dind't really seem to work, no side-effects
Duloxetine (Cymbalta)- (forgot dose) completely lost libido (odd numb feeling from waist down)
Amitriptyline (Elavil)- (forgot dose) weight gain, sedating
Venlafaxine (Effexor)- 70mg, weight gain, excessive sleeping (17 hrs on weekends), lethargy
Trazadone (Desyrel, Oleptro, Desyrel Dividose)- 300mg, once asleep would sleep for 10 hours

Anti-anxiety:
Alprazolam (Xanax)- 2mg; sometimes put me to sleep, sometimes no effect
Lorazepam (Ativan)- (forgot dose), worked at first, then within a month stopped working
Klonazepam (Klonopin)- (forgot dose), worked at first, also stopped working
Diazepam (Valium)- 10mg?, didn't work at all... zero effect good or bad.

Current meds combo-
(2 months so far; best psych results so far and virtually no side-effects as I can tell yet)
Prozac 40mg/day, Trileptal 600mg/day, Seroquel 100mg as needed at night (for racing thoughts)

Whoa. Okay, I figured people had been through some trial and error, but when I thought I had it bad...

Interesting. I'm surprised they tried so many different combinations! I'd love them to give it a shot with me. I'm diagnosed bipolar, and my psychologists seem to agree I have borderline personality disorder too. I've got anxiety (especially social anxiety) and some paranoia.

I don't have your history for sure, I was only diagnosed last November, but my symptoms had been around forever. When I began the long mental health journey (well, the curative part of it), I thought I was just depressed, so they put me on antidepressants:

Lexapro (escitalopram) - Lasted 8 days. Threw me into rapid cycling at an insane rate. One minute down in the dumps, a little time goes by and like a switch, I feel normal. Oh, I guess this is working. Two minutes later, depressed again. NO. FUN. By the end of it, I couldn't take my thoughts off death, even if I tried to think of something else, my thoughts would loop it into relating to death... it was really horrible. They took me off that as soon as I saw my PCP again, and put me on:
Effexor (venlafaxine) - Lasted 3 days on this, effects much the same as above but progressed faster; thoughts of suicide appeared earlier.

On both of them, I had nausea and no appetite.

This was when I was diagnosed bipolar, so the psychiatrist started me on:

Lamictal (lamotrigine) - Took about a month to work up to the right dose (avoiding the rash and stuff), and did nothing discernible on its own. Added:
Lithium - After 2 months on the Lamictal with no results, 600 mg lithium added. Helped very slightly, I think, but I got suicidal again after a month or so on it. Also made me super hungry, I gained about 10 lbs because I couldn't stop eating.

I went into a partial program at this point because my stupid doctor wouldn't listen to me telling him I was suicidal. Doc there added:

300 extra mg lithium - Realized that my saliva was suddenly oddly salty. It still is. I also began having huge dizzy spells in the middle of the afternoon (was taking meds at 10:30 am, 4:30 pm, 10:30 pm). At one point I thought I was going to pass out and drive off the road so I went to the E.R.; they attributed it to dehydration. So I had to learn to drink an obnoxious amount of water every day because lithium's tough on your kidneys...
Wellbutrin (bupropion) - This is my wonder drug. I have no idea if it even works for my depression or anything, but it does combat the hunger from the lithium, and helps my metabolism.
Klonopin (clonazepam) - Makes me feel completely drunk, except I don't slur or say stupid things or do any of the other dumb things you do when you're drunk. I do wobble around and bump into things and knock them over like a klutz though. Oh, and it works. It works nicely.

I'm seeing the psychiatrist Tuesday and we're gonna have a talk about what else we can do; I don't feel stable on this combination right now. Better, yeah, but definitely not where I want to be.

Hey Koshka! And fellow cyclothymics!
I think this is super helpful! Not that this should ever take the place of your doctorʻs advice, but I have spent countless hours on the internet finding out what has and hasnʻt worked for other people, and what side effects theyʻve experienced though those vary, as well. Iʻve had my own trials and errors though my history and pharmaceutical list isnʻt nearly as long! My first pdoc was old school and put me on:
lithium carbonate 1200 mg. Seemed to work fine to stabilize my moods, but weight shot up from Feb til now a good 40 pounds. She insisted it wasnʻt the lithium. My new pdoc showed me that weight gain is common with lithium.

wellbutrin/bupropion 2 pills a day was my antidepressant that worked well to keep me on the up swing but the lithium kept me from becoming hypomanic. This one worked well for me. With my new doc, Iʻm on wellbutrin XL which is a slow release 24 hour which I like much better.

Back in February, I wanted to address my premenstrual magnification that rears its ugly head during the luteal phase of my menstrual cycle. Experimented with lamictal. I really liked it, but when my day 14 came around, the beastie still reared her ugly head. Being the cyberchondriac I began searching for some possible treatments, I found nefazodone to have been effective for some women. The first two weeks of getting on that drug were SPOOOKY! I was OUT OF IT! Once I adjusted, two weeks later, those side effects disappeared and I noticed an improvement. When I titrated up,however, I started to experience bizarre side effects... chills under my skin at 3am, turns out I had serotonin syndrome which if left untreated could have been fatal. the combo of the nefazodone, lithium, and wellbutrin was way too much serotonin. had a blow up with my pdoc, malpractice was not a word she like to hear, and now Iʻve found a wonderful doctor who is changing me up completely.

I am experimenting with topamax. so far so good. slight slippage, memory recall loss, but not lately. No real struggle with word loss, knock on wood! I want the weight loss perk! (I hear it kicks in at 100mg and Iʻm just at 50) If it makes me too ditsy or too moody and irritable, Iʻll go back to lamictal. On the wellbutrin, off the nefazodone and will take prozac just for five days mid cycle for my PMM. (premenstrual magnification). This is actually quite interesting. Journal your cycle. Count day one as the first day of your flow when itʻs red. I find that day 13 or especially day 14 is the day I am at my most volatile. Iʻm simply unfit to be with people. It varies. It isnʻt ALWAYS extreme. But when itʻs extreme it can be scary. Iʻve been in such fits of rage Iʻve almost thrown televisions through the air. The worst moment was when I was furious at my daughter for the stupidest thing, was shaking with rage, had to flee the house, drove away and actually had a suicidal thought. Thatʻs what caused me to seek help. Those of us with a manic-depressive disorder actually experience a point in our cycle when our symptoms become exacerbated. Iʻll let you know how the prozac works for me. My pdoc said that itʻs been quite effective for her other patients who suffer from the same thing!

Summerlily- hang in there and be persistent... keep tweaking until YOU feel right. It can be pretty maddening to go from one med to another med to upping doses and adding this and adding that. In and of itself, all this switching and trialing can exhaust you. But wanted to pop on here and tell you I know EXACTLY how you feel. Persist until you feel that you are stable.

F&R- Hola chica! OH MY, can I relate to the PMDD (Premenstrual Dysmorphic Disorder... same thing as you guys have a different name for). Top it off with some ovarian cysts, and my monthly cycle is about as fun as having your toenails pulled off with tweezers. I'm on Prozac too. Years ago they put me on it the same way as you... during the PMDD time. Didn't really notice a big difference then, but being on it full time now, it does help a bit. I also have suffered from MASSIVE cramping (to the point of passing out) from day 14 till I bleed (yeah, HALF A DANG MONTH). A couple of months ago I started taking an OTC herbal supplement for pre-menopausal women (I'm heading down that path now) and it helped AMAZINGLY. It's just a combo of herbs meant to calm moods, cramps, PMDD, nite sweats, etc. I figgered it was a crap shoot since nothing's really worked my whole life. But this stuff amazed me... takes 30 days to get in your system to notice full effects. It was my wonder drug. I've been missing doses over the last month due to me not paying attention to my herbal supplements while traveling... and you guessed it.... UGH DAY 14 IS BACK!!! So back onto them miracle pills I go. Don't know if you have anything like these at your grocery store, but thought I'd mention it. Brand is "Estroven." Might not work for everyone, but they have helped me tremendously.

Hugs to you both
K

Prozac- Had extreme Paranoia and dissociation. I don't know in particular, as there were some really, really abnormal things, out of my control happening around me at the time.


Luvox- No effect. Only serious instability and irritability. I had it for a year and it didn't help with my OCD at all, and only triggered very drastic mood shifts and Dysphoric Hypomania. At the time, I felt entirely 'drained' and was only re-diagnosed after I started taking this medication.