Wednesday, November 18, 2009

Even more changes

I am fighting terrible anxiety still since moving to the MAOI. So my med list is now this:

Emsam (MAOI) patch 9 mg/24h
Lithium 300 mg
Seroquel XR 600 mg
Nuvigil 150 mg
Synthroid 100 mcg (although I'm pretty sure that's way too low; I'll know in a week or so)
Amelioride 10 mg
Vitamin D (I have a significant deficiency and am now on maintenance)
Valium (1/4 of a 5 mg pill per day)
Klonopin 1 mg twice a day
Vistaril as needed (usually once per day)
Miralax one scoop (I'm off all other bowel meds, which is very amazing)

Things may change tomorrow. I had a fall today that is likely from meds. So who knows what comes next. This combination is the only way I've felt good in months, but I am well enough now to survive if I have to give up some anxiety meds. My depression is lifting, slowly but surely. Unfortunately I'm also developing some patch reactions, which I could live without, but it's common and someone will know how to help I think.

Monday, November 9, 2009

Everything has changed

I thought I updated this list not terribly long ago, but either a year has flown by or I didn't succeed.

So, here's the backstory:

When I last wrote I had needed to increase my antidepressant (imipramine) to 70 mgs, which was a high dose for me since I was sensitive to it and got manic rather easily. I never went off that dose. Between January and July I tapered totally off of Depakote, amazing everyone. My last dose of Depakote was July 12, so it was totally out my bloodstream about the 17th. On the 24th I lost my job.

Depression hit hard that time and I went up to 80 mgs, then 90. The doctor said I could try 100 mg but that I probably wouldn't tolerate it. She was correct. After a bit 90 mgs was too much, so I backed down to 80. 80 mg helped the depression, but caused such severe constipation that I was hearing way too much about "colonoscopy prep", "suppositories", etc and I was taking way too much medication for that part of the body.

That left a big dilemma. I could back down to 70 mgs and hope it worked, but that meant never having anywhere to increase the dose if needed, and it generally is needed in the fall. Or I could change meds proactively. That's what we decided to do and I tapered off the imipramine for a month. The only option I had left was an MAOI and there couldn't be a bunch of imipramine in my blood when I started that.

So I did that and spent last week in the hospital getting onto the new med (Emsam; it's actually a patch) and being safe while coming off the old one. In the course of things a lot got changed around. So, at the moment I'm taking:
-Emsam, 1 patch daily. 6 mg/24 hours
-Nuvigil 150 mg daily
-Amelioride 10 mg daily
-Synthroid 100 mcg daily
-Seroquel XR 600 mg
-Lithium ER 300 mg
-Klonopin 1 mg twice daily
-Vistaril 50 mg once daily as needed (meaning once daily)
-Vitamin D weekly

That's a big difference, since when I went to the hospital 2 weeks ago I was taking:
-Imipramine, tapering
-Lithium 300 mg
-Seroquel XR 300 mg
-Synthroid 137 or 187? Can't remember mcg
-Amelioride 10 mg
-Nuvigil 150 mg
-Ativan PRN (which was pretty frequently the last few weeks of this)

So, that's life today.