Posts Tagged ‘Wellbutrin’

Honestly, NOBODY could be any worse. That “Weakest Link” woman would make a more supportive ear.

Friday, June 4th, 2010

For some reason every time I cut or paste anything into Word recently, it adds “A FAIR AND EQUITABLE DISABILITY TAX CREDIT” to the top of whatever I’ve inserted.  Just like that, in all-caps.  I can’t recall ever adding that phrase to my clipboard, but it is apparently something my computer feels strongly about.

More power to you, computer.  More power to you.

…Just not too much at once.  That’s what the surge protection power bar is for.

So my psychiatrist is still an asswipe.  I was not as firm in my conviction after the previous appointment as you all were.  I make a lot of excuses and allowances for other people, and do a lot of analyzing over any potential biases or misperceptions on my part.  Nope.  Definitely an asswipe.

Perhaps a well-intentioned asswipe, but an asswipe nonetheless.

Beyond the priceless “Meh, just continue to take the disruptive and ineffective medication forever” comment from last time, I’ve added a whole new level of wrong from the most recent appointment.  Like, seriously, unbelievably, kick-in-the-teeth wrong.  A wrong so sparkling clear that even I can’t justify it away.  …Which is probably a good thing, since it’s given me the certainty to ramp up the timeline on looking for a replacement.

I went into my last appointment with a pretty good idea of the direction I was hoping to take with things.  The way I figured, if I do manage to successfully finish getting clear of the Luvox, I am never, ever, ever going to want to go near another SSRI again.  …Which is probably okay all things considered, since even ignoring the side effects most of them seemed to make me much worse rather than any better.  Still, though, if I was going to give anything along those lines a shot, this would be the time to do it.

The only time that I’ve noted a significant improvement while on medications was over a year ago, when for a brief period I was taking Cipralex and Wellbutrin.  I was also meditating and taking good care of myself, and in quality therapy, so it’s hard to say what was the defining factor in the improvement, but if it’s possible medication has helped me, that would be the time.  The Wellbutrin by itself this time around has been…different.  I think it’s making at least a small positive difference, but it hasn’t been nearly the dramatic experience of those few weeks last time.  So if the medication was responsible for the improvement, it was either a difference in my reaction to the particular generic brand I was taking that time (which the doctors seem to think is impossible, but I have heard from others has been their experience too.  I had way different and harsher side effects last time too, which I find odd if there is apparently no difference in how the body reacts to them), or it was the combination of Wellbutrin and Cipralex together (the Cipralex by itself gave me nothing but side effects).  This seems possible.  One of the major random changes at that time was that I didn’t give a crap what anybody else thought of me, and Cipralex is often prescribed for social anxiety too.  So if I was going to give something a try, it seemed to make sense to try out that combination again now that I’m on a version of Wellbutrin that doesn’t give me hives.  …Right?

I’ve also now amassed an unfortunate quantity of evidence that “average” doses of these medications are WAY too much for my particular chemistry.  I’ve also come across a number of cases in my research in which too high of a dose of antidepressants has had a huge negative effect on a patient’s mood, while a lower dose actually helps them quite a bit.  So I’m thinking, since we’ve reached the stage of “throw random pills at it in case something happens” anyway, why not try a smaller-than-conventional dosage of an SSRI?  And since I’m on the Wellbutrin anyway now, and the Cipralex might have been helpful in combination, why not try that?  Add a little dose of Cipralex.  If it works, great.  If it doesn’t, I haven’t lost much, and I can just wean off that one instead.

…Except this is how the appointment went down.

-First thing, P-doc asks how things are going as he usually does, and I mention noticing abnormal and dramatic anxiety (almost certainly a side effect of the corresponding doubling of my Wellbutrin dosage). He asks for details and examples.  I explain my barbeque meltdown.  He proceeds to spend ten minutes or so telling me why my reaction to that situation was illogical (and not in a “change your thinking about the event or reframing” kind of way, but in a “that’s dumb.  You make no sense” kind of way).  I tell him that, yes, I recognize that.  That’s why I’m calling it “abnormal” and “dramatic” and am thinking that it needs to be fixed.  He continues to tell me why it’s silly that it upset me at the time.  I grit my teeth and try again to tell him that I realize that.  If I was anxious because there was a bear in my house, I would not have mentioned it as a problem.  He again tells me why my reaction makes no sense.

-P-doc asks me what I plan to do from here.  I ask for clarification of the question.  He seems to be talking about work.  I tell him that depends on what kind of a difference there is in things once the depression in under control.  I’ve likely been depressed the whole time I’ve been in my career, so it’s hard to say what difficulties are a result of the job and which are a result of the depression.  I say that obviously I wouldn’t be able to handle it now, but that I hope it might be different once I get into some treatment that’s working for me.  He looks confused and gruffly says “what do I mean I couldn’t work now?”  Um…that I’ve been curled up on my sofa the last several weeks, so nauseous I was afraid to move?  That just before that I was sitting in a parking lot literally for hours, crying so hard that I couldn’t drive myself home?  That until recently I haven’t been able to stay conscious for a consecutive six hours during the work day?  …And that’s if you ignore that whole “depression” thing that they pulled me off of work for in the first place.  You  know, the part where envisioning killing myself was calming?  We’ve talked about this…  He brushes me off.  He asks me why I would want to change my job.  I detail all of the ways that it feeds into my biggest problems and stressors, and how I end up working myself to the bone.  He says clearly I need to change my job.  What did I like about my job?  I detail the thinks I really liked and found fulfilling.  He says I love my job.  I say…um…refer to previous list.  I alternately love and hate my job.  He asks me what I dislike about my job.  I repeat my previous list.  He brushes me off by telling me every job is stressful.  I try to tell him that I thrive on some types of stress and give some examples, but that the particular stresses of my current situation aren’t good for me.  He brushes me off by telling me every job is stressful.

-In addition to the anticonvulsant he has now prescribed for the sleeplessness that was a side effect of the Wellbutrin, p-doc now wants to prescribe an antipsychotic medication as well, because it sometimes has heavy sedative effects and might counter my anxiety.  I tell him that the anxiety was so strong only since the increased dose of Wellbutrin, so since he has agreed to lower the dose back down, I don’t think I need more medications to deal with the side effects of other medications.  He tells me to take the antipsychotic.  I tell him I am not really comfortable adding another medication unless absolutely necessary since my body seems to be so sensitive to side effects.  He tells me to take the antipsychotic.  I tell him I am not sure I want to add another medication to the mix while my dose of Luvox is still not stable, since it’s still having a significant effect on my physical and emotional situation, and I wouldn’t be able to distinguish whether problems or benefits I noticed were related to the changes in Luvox, or to the addition of the new drug.  He tells me to take the antipsychotic.  Then he tells me the effects of the Luvox are all in my head.  I remind him that we did not one, but TWO double blind trials which he had previously agreed determined beyond reasonable doubt that I was sincerely reacting to the Luvox and not imagining things or creating them for myself.  He brushes me off.  He taps his index finger to his temple with a condescending knowing look.

-I explain the reasoning I outlined above, and ask if it would be possible to try a very small dose of Cipralex.  He asks me if I want to try a full dose of Zoloft.  I repeat my reasoning about Cipralex in particular, and smaller doses in general.  He asks me if I want to try a full dose of Zoloft.  I say no, but that if I was going to explore the Cipralex option, I would like to do that before I go to all the work of getting off the Luvox completely, because it has been unpleasant to say the least.  He taps his temple.  All in my head.

And my very, absolute favourite,…

-When I begin to get frustrated that he is not in any way listening to what I am saying, or addressing my clear level of discomfort with the treatment he is suggesting, he tells me in the most patronizing way possible and with a “pat pat” hand gesture that I should take the antipsychotics because they will “calm me down.”  I am in no way hysterical or anything.  I just have some concerns that he has not yet addressed.  I continue to present very rational points that I would like addressed before we proceed.  He gives me the condescending knowing look of “see, you’re agitated” and tells me again in that placating way to “take the antipsychotics.”  I continue to try to ask about concerns.  He cuts me off and tells me to “take the antipsychotics.”  I explain to him that the levels of uncomfortable anxiety I’ve had have come from the Prozac and the Wellbutrin, and are not an intrinsic part of my personality without those drugs in my system.  He cuts me off and tells me to “take the antipsychotics”.  He did this several more times, all with that look on his face that said clearly I was irrationally anxious and not REALLY FUCKING FRUSTRATED because the outcome of all of this is kind of important to me and he was being an insensitive douchebag and would not even HEAR OUT WHAT I WAS SAYING.  I swear that man didn’t register one thing I said the whole hour.  Not that he heard me and disagreed, but just simply didn’t listen.

-Then he tells me that he’s going on vacation for a little over a month.

I am not sure that I have ever been so frustrated.  Not being listened to, especially about something important, is one of the very few things that can get me truly irate.  This is the kind of thing that I have nightmares about.  Nightmares in which I bite off people’s faces.

So in conclusion, I will be asking for a referral to see someone else, and in the meantime am hoping that my family doctor will be willing to support me in making a change and take over my medications for a while.  I’ve also started daily meditation again, which I think was crazy helpful last time.  Ideally I think I’d like to just focus on that for a while and give myself time to get off the Luvox before adding any more craziness to the mix.  I don’t even know what I’m like anymore without side effects.

At any rate, there is stands.  And I would very much like to take the antipsychotics, and shove them somewhere very unpleasant for him.

Traumatized, I tell you.

Friday, March 26th, 2010

So the p-doc now thinks that my body was so traumatized by the Effexor withdrawal I went through last year that now the signal of lowering my dosage of SSRI is triggering it to go bat shit crazy all on its own.  So it’s not the Luvox.  It is me.  My own sweet body, making me dizzy and nauseous, and plummeting levels of certain chemicals, and getting my brain to electrocute me.  Great.

I’m not sure how much I entirely buy it yet (he’s suggested some things to try in order to prove or disprove it).  I’m also not entirely sure which verdict I’m pulling for.  Would feel like a bit of an idiot if it’s my own chemistry sabotaging me and putting me through all of this.  But on the plus side, I might be able to get clear of the Luvox more easily.  And it’s the option that doesn’t involve me vomiting all day as a result of the testing.  Also, I would have the MOST POWERFUL BRAIN EVER.  Which is kind of cool on its own.

But damn, if it can affect my neurotransmitter levels that strongly, then somebody tell me what I need to do to kick this whole depression thing and just get my brain doing that for me instead.  Also, I would like some weight loss.  And x-ray eyes.

Had another night of crappy sleep last night combined with my now-patented 4 or 5 am awakening.  I literally let out a “You’ve got to be fucking kidding me” today when the morning alarm went off.  And I was still fully awake to hear it.  This says something, as unless I am driving or playing video games, I am not naturally a big swearer.  I say scathing things, like “crap” and “drat.”  I reserve the right to moan and whine about the frequent awakening a little, as I do not have babies yet.  I’m sure all of the new moms are rolling their eyes a little, but can probably sympathize.

(except that if you’ll read above, I’ve patented it now.  So you’ll owe me.)

The Wellbutrin continues to make a positive contribution aside from the sleep thing.  According to my mind, this is apparently cause for much celebration, followed by an instant of panic that I may be put back to work, followed by some worrying about trying to deal with that side of things and the decisions surrounding it, followed by the rationalization that if it causes so much panic still I’m probably not yet well enough to go back, followed by a moment of relief, followed by another moment of panic that they might send me anyway, followed by lunch.

Mmmm.  Lunch.

Vroom

Tuesday, March 16th, 2010

I am internally curled up in a little ball of anticipation.  And attempts to quell my anticipation.  And then more anticipation again.  But I think the Wellbutrin might be working.  Shhhh.  Don’t scare it.

In worth-it-anyway-if-it-actually-makes-me-feel-better news, I am also doing the bright-eyed 4am Wellbutrin Wake-Up again.  I was up for over two hours this morning, between 4 and around 6:30, at which point I promptly fell into a shake-me-at-your-own-peril, drooling sleep of death between snoozes on the alarm clock (which was set to go of at 6:20).

The interesting thing about the early morning thinkfests is how vividly different they are from any of my usual bouts of occasional insomnia.  Generally if I have difficulty sleeping it’s because I’m having trouble shutting my brain down.  So I’m thinking too much, or planning too much, or worrying too much, but I’m tired.  And the longer it goes on, the more I’m desperately wanting to JUST BE ASLEEP ALREADY.

With the Wellbutrin in my system, I do have difficulty stopping my brain from thinking, but that’s because it is POWERED WITH MAGIC.  And puppies.  And maybe a Kenyan.  It is this, in my brain, all night long.  I do some amazingly clear thinking at those times, though.  For some reason my mind works twenty times better in those hours than it ever has in my daylight life (This is a factor of the Wellbutrin, not the time of day.  I have been awake previously at 4am.  It was not productive.).  I easily manipulate information in these hours, and see the essence of problems, and have a vast pool of creativity, with extra creativity dripping out the edges because that’s JUST HOW CREATIVE I AM.

I make plans in these hours while I’m lying there in bed, and make peace with my whole life, and appreciate others, and solve the world’s problems (and sometimes I blog).  And in the most amazing of amazing twists, it all still makes sense in the morning (except that I have more difficulty grasping it all at once)!  Unlike the stuff I usually scrawl down on the paper beside my bed while in a sleepy haze.  Have you ever had one of those moments where you think you’ve just come up with something totally fantastic, and then wake up the next morning to find out that it involved elephants.  And pastry.  And that you were probably still a little asleep?  I have.

My brain just plain works better in those hours.  Someday I should get out of bed and take an I.Q. test, just to see…  I seriously think it could be many points higher.  Or maybe it’s just a right-brain thing and I’d bomb the test, but either way it would be interesting to see.

At the moment, I am going to get an extra cup of caffeine.  Because as much as coming up with practical ways to eliminate the concept of “mistakes” from my life is useful and all, those extra two hours of sleep would have been handy too.

Please tell me that you have that stomach line too…

Friday, March 5th, 2010

Sometimes the fake “words” in those little prove-you’re-human-and-not-a-spam-computer text boxes amuse me.  Got “vichinga” yesterday, which sounds to me so very, very much like a pet name for female body parts that I may start using it.   Or maybe as one of those “Ha – gotcha!” kind of phrases.  Like “Yo mama’s so fat she probably needs medications to assist in managing her cholesterol!  Vichinga!”  or  “Your husband’s so lazy that there appears to be a minor buildup of recyclable products under your sink! Vichinga!”

Also nice guys do sometimes finish last.  Mostly in yo mama battles.

Day two of the Great Wellbutrin Countdown.  I am happy to report that there are no hives yet, though I have become excessively aware of everywhere on my body that is minorly itchy, at all times.  Incidentally, that line at stomach level, where you fold when you sit down with bad posture?   Very itchy.

I filled out the Anxiety and Depression inventories in my “Feeling Good Handbook” by David D. Burns today (the one with the admittedly very famous in the field man on the cover who looks very much like Mr. Rogers’s nicer, more syrupy neighbour).  The depression one is sort of like this.  They say that it can help to do that regularly, since it puts a definitive number on how you’re feeling.  I don’t know how much weight the actual number itself holds, since the test is pretty basic, but it does make it easier to make comparisons.

I haven’t kept track of all of my scores over time.  Don’t remember exactly where I was when I first started (early 30’s, maybe?).  At one point earlyish into the process, not too long after being diagnosed and pulled from work, I was a 42(anxiety) and 28(depression).  Later on after doing a lot of my self-help readings and trying yoga, etc. I was a 28 and 20.  Then 38 and 16 on the Wellbutrin the first time around (it’s known for making people a little tightly wound).  When the Effexor hit, I was too depressed to even think about answering the questions (it would have been off the charts) and on the Prozac I was too anxious to worry about it.  Today I scored a 42 and 40.  The anxiety checklist goes all the way up to 100, but the highest possible score on the depression checklist is 45.  Note that I tend to under-estimate my symptoms if I’m undecided.  Note also the difference between where I was when they officially decided this was bad enough that I could not work anymore, and where I am today.  Note that higher is BAD on this test.  Sigh.

Yo body’s so cracked that you get SADDER on antidepressants!

Vichinga.

Hives are only fun when they are on T.V. and full of bees.

Thursday, March 4th, 2010

So I am now quite officially a total oddity (which yes, we all already knew…).  My p-doc yesterday told me that he has never, ever, in his entire long career, heard of anyone having any withdrawal effects when discontinuing Luvox, unless they were taking high doses for a very long period of time and then stopped very suddenly.  I was taking the lowest dose.  I took it for a month.  I have discontinued as gradually as humanly possible.  I was shaving edges off the pills!

In addition to the crazy emotional sensitivity, and extended sobbing fits, and calming thoughts of suicide, and dizziness, and nausea, and desiccated-head-feeling, I am having the metallic twang sound again today sometimes when I blink (Which as nuts as it sounds is actually a relatively common side effect in cases of bad discontinuation syndrome.  So the internets told me when I thought for damn sure I must have been losing it).  I couldn’t make that shit up if I tried.

I am a freak of nature.  Document me.

Historically, as yesterday, any well thought-out plans (or partially thought out plans, or any plans at all, really) tend to go promptly out the window when I am actually sitting in my psychiatrist’s office.  I get the impression that his career has made him very adept at trying to keep control of a situation, and guide people where he needs them to go.  I can understand that.  In terms of severely mental ill people, I am a roll in the park with fuzzy rabbits.  Tough habit to break though, I think.

At any rate, I am not now taking a break from the medications, or waiting until I have weaned off of the Luvox fully before adding anything to the mix.  He tossed me a sample bottle of name brand Wellbutrin.  I took one today since it isn’t supposed to interact with the little Luvox pebbles I’m still working on.  Now we get to wait and see if I break out in hives.  The hope is that the whole period of time when my skin COULD NOT HANDLE ANYTHING TOUCHING ME was more of a reaction to the fillers, colouring, etc. in the generic brand pills than to the medication itself.  Worth a try.  Things did seem better on the Wellbutrin.  I can’t bring myself to get my hopes up anymore, but it would indeed be pleasant if this worked out.

Next step after this is looking into mood stabilizers instead of antidepressants.  My p-doc broached this subject by out of nowhere asking me if I ever get high.

And yes, my brain interpreted that question in probably exactly the way that you are now.

High like manic, he meant.  High like manic.

That’s the part where you think that you’re great and get an over-inflated sense of your own capabilities and feel unstoppable and smart and creative and wise and sociable, right?  No.  No I don’t think so.  …And can we go back to that part where I thought you were asking about drug use?  Because that’s going to eat me up for a while.

I miss my happy pills

Friday, July 3rd, 2009

So HOLY CRAP are things harder now that my Wellbutrin is gone.  I’m not the kind of person to generally hide behind labels, but any tiny doubts about whether anything is physically wrong with me are totally and completely gone.

It was hard to tell at times before, because moods and reactions obviously shift greatly depending on what outside stresses are going on, how we’re doing emotionally in general, etc.  Having suddenly experienced the with and without medication experience while the other parts of my life remained constant has brought the difference into pretty vivid focus.  I was getting pretty good at rolling with the punches.  They’re weren’t punches… they were just fist hugs.  Now I’m back to weeping in the car because something in my husband’s tone has indicated to me that he disapproves of my desire to have sushi for lunch, and I simply cannot handle that.

Sigh.

I had sort of forgotten how difficult everything could be, to be honest.

Fingers crossed that the next med they try will have the positive effect but without all the puffy red itchiness.

Don’t ask me how I got a patch on my left eye and the inside of my ear

Monday, June 22nd, 2009

My home practice for the meditation course this week let me alternate body scan with mindful yoga.  This was happy and welcome news, as the body scan and I have not always been getting along well.  Yoga is infinitely more pleasant, if only because I can remain conscious while I’m doing it.  The process of changing activities and sensations frequently also means that my thoughts are drifting a lot less frequently.  Anyway, a pleasant change.

My body is still producing lasting angry red patches whenever I use my muscles or something contacts my skin.  Like,…oh,…underwear.  Or other parts of my skin.  Those kinds of crazy things.  I am undeniable quite itchy, and have resigned myself to the fact that I will likely need to revisit the doctor.  Does it say something for my desperation that I was giving serious consideration to whether I could cope with the itch forever if it meant keeping my Wellbutrin?

I am a determined little thing sometimes.  As noted above, most days I chose to do the yoga rather than the stationary body scan.  The yoga where I use my body a lot, and, you know, contact things.

I am itchy…but flexible.

In which I use a naughty word

Friday, June 19th, 2009

Yesterday I had no spots at all.  Was joyous.  Today I woke up covered.  No help yet from the allergy stuff.  In the need for sympathy for my plight, I feel the need to pass on that there is now a big itchy red splotch on my elbow, between my eyes, and in the CRACK OF MY ASS.

That one will be fun to scratch in public.

Come on, red dye #12!

Wednesday, June 17th, 2009

Had the dubious pleasure of watching large red spots form on my skin while in my doctor’s waiting room.  A series of raised white bumps on my right knee as well.  Kind of interesting, if they weren’t so damn itchy.

I’m on allergy medication now, and have lowered my dose of the Wellbutrin again.  Fingers crossed that it was just a reaction to the dyes in the generic kind they gave me.

(The correct answer is c)

Wednesday, June 17th, 2009

Ah, Wellbutrin.  Why must you taunt me.

Things seem to be progressing fairly well with the medication (aside from the fact that every now and then my neck decides it would be fun to see if it can get the top and bottom to touch, and every now and then my muscles want to move without my permission).  I don’t feel “normal,” but there does seem to be progress in the right direction, which is great.

…Except for the itching.  I just went up slightly in dosage (from 100 to 150).  My previous dose was extremely low, but my doctor knows that I’m prone to side effects.  The new dose is also very low, but within a couple days of starting it, I began to itch.  Didn’t pay too much attention to it at first.  The next day it was significantly worse, but I’ve been packing and cleaning a lot lately, so I sort of figured maybe it was from cleaners, or dust, or…very tiny insect packs?  Today I am undoubtedly itchy.  The kind of itchy that really requires capital letters.  I am ITCHY.  Too itchy to attribute to something mundane.  It varies a bit in intensity and location, which is part of why I thought at first that I might be imagining things.  First the palms of my hands and soles of my feet are driving me crazy.  Then it’s the side of my finger.  Then my back.  Then just at the hairline at the back of my neck.  Then the line where my legs join my torso (which I don’t really want to be scratching in public).

After determining that, no, I am not in fact crazy, I went to the internet.  As it turns out, lots of people have recounted exactly what I’m experiencing.  Intense itching, beginning in the palms of the hands and soles of the feet, then moving randomly around other areas, particularly in joints (like where the legs join the body).  Good news, I am not imagining things.  Bad news, many of those people mentioned waking up the next day covered from head to toe in huge red welts, or with their eyes swollen shut.  And having to discontinue the meds.

I am going to the doctor today.  Maybe it’s just something in the dye from the new pills.  Maybe it will become manageable over time.

I think that should be the real depression test.  Suppose that a pill you were taking caused you near-unbearable side effects, but made you feel slightly better.  Would you

  • a)  Stop taking the pills immediately and start a class action lawsuit.
  • b)  Stop taking the pills immediately.
  • c)  Gauge how life-threatening the side effects are likely to be, because  you’re worried that if you report them to your doctor they might take the pills away.

Darned risk of fatal allergic reaction.