Medications

As well as owing my life to my husband and the support of a few good friends, medications have made a big difference in my life.

It was being on a medication called seroquel (an atypical “antipsychotic” that is approved for bipolar depression when other medications fail) that helped me have five settled years with no depression and only rare hypomanic episodes.  But unfortunately when I fell pregnant with Rose, the seroquel just stopped working.  Seroquel alone was enough for those five years but to get me to the point of being well, I’d had to take a combination of Luvox (an antidepressant) and lamictal (a mood stabiliser) in the year before.

When I became depressed while pregnant with Rose, my GP wanted to put me back on luvox.  The theory being that it worked before when I was severely depressed, so it would work again.  He recommended this to the psychiatrist I had started seeing while  pregnant (Dr C) who rejected the idea for complex reasons that were wrong, but that’s a topic for a different post.  When I first saw Dr A in March this year, she wanted me to start on lamictal, before I even told her I’d been on it before, and even more so when I told her I’d been on it before.  Lamictal can cause birth defects and at the time, I didn’t have a reliable form of contraception (waiting to recover from having Rose before looking at long term methods) so I decided not to try it.  My GP recommended the luvox again, so I started that in March, but it didn’t work for me either.  I gave it 6 weeks but it made no difference at all.  I kept getting worse.

By then, I not only stopped it, but stopped the seroquel too.  I’d given up on anything working.

I was waiting for another appointment in May with Dr A.  I don’t think at our first appointment in March she realised how unwell I was.  I don’t blame her.  I went out of my way to hide from her how bad I was.  So she recommended I come back in 6 weeks (which ended up being 2 months with her being away on leave).  And she had prescribed me the lamictal so she tried to treat me.  I was seeing Dr C regularly though.  I had told him 90% of how bad I was so, even with his explanations, it still makes no sense why he didn’t try medication to treat me, especially after I stopped the seroquel in April.  Even when he did realised I was severely unwell in May, his only answer was “wait until you go into hospital before starting new medications”.  My GP had wanted me to start Cymbalta when the luvox failed, but Dr C wanted me to wait until I went into hospital.  I do understand with my history of reacting badly to some medications, starting a new medication is a worry, but leaving a severely depressed and suicidal person unmedicated for nearly a month was dangerous and nearly cost me my life.

Eventually I was put into hospital in the last week of May, and Dr A started me on Cymbalta for my depression (and my GP had also recommended it to help with my fibromyalgia pain) and on abilify, another atypical antipsychotic that acts as a mood stabiliser to prevent the cymbalta from making me manic.  I was on 30mg Cymbalta and 5mg Abilify.

I was very lucky.  I was admitted and started on the medication on Tuesday. The medications kicked in very suddenly friday afternoon. I had been planning to kill myself the following monday.  I was discharged after 18 days.

When I got home, I did actually ended up going hypomanic even with the abilify.  It wasn’t a bad thing.  I made heaps of progress dealing with my hoarding (part of my OCD) and had a really great time for the two weeks it lasted for.  I sometimes wish I could always be like that.

Things were good but Dr A decided to increase the Cymbalta to 60mg.  A good thing.  Things stayed good after that until I went back to work in the first week of August.  In the second week of August, when I started on the surgical ward where I work now, that’s when things started to go wrong again.  I was so anxious about work, more anxious than I’d ever been in my life (and I’ve been very anxious before).  Eventually the anxiety led to severe depression and the thoughts of self harm and suicide and by the end of August I reached the point where all I could think of is I’d rather be dead than go to work again.  Dr A increased my Cymbalta to 120mg to try and help with the severe anxiety I was suffering from.  I really didn’t believe it was going to work and stopped medications altogether but after 4 days, John talked me into giving it a chance.  So I started the higher dose of the Cymbalta.

I haven’t gone back on the abilify.  With my history of hypomania being a really good thing for me – I don’t do anything impulsive or silly or dangerous or destructive – my thought at the time was I don’t really care if I have hypomania or even mania.  To be honest, I still don’t really care which is why I haven’t gone back on it.

The higher dose of cymbalta did work.  It took just over two weeks this time, but in that time trying not to kill myself was so very hard.  But once it kicked in, it made a world of difference.

And that’s where things are now.  I’m taking 120mg of Cymbalta and nothing else for my mental health.  Things have been going well the last few weeks since starting it and here’s hoping it continues!

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