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help with pdoc appt (long)

Posted by lepus on February 15, 2004, at 17:26:51

I have a pdoc appt coming up and I need some help and would love some from all the wise PBers. First, I am going to give some history on myself and see what you guys think about what med direction I need to go in now.

I was dx'd with panic disorder when I was 11. I had all the classic signs of panic disorder at that time. No abuse is in my history that brought on the panic. I assume it happened due to family history of the disorder and hitting puberty. I was put on Imipramine and everything was basically fine until I hit 16. At that time I smoked a joint that I think was laced with something and had a psychotic break for the rest of the night much like being on LSD. I have not used drugs since. From that night on however I started to have disassociative symptoms and the anxiety came back worse than ever. I went to the psychiatrist where we tried so many things, basically every class of drugs except MAOIs. I am sorry now that I didn't write down every drug we tried and in what combinations. As time went on I got better but was never really the same as before the pot incident. I should say that Klonopin seems to have been the wonder drug to get me out of the anxiety at this time. I still take it today.
When I hit my early twenties I would have times where I was fairly functional with just a low-lying depression and then would have days where I just couldn't get out of bed. I would sleep all day and then be up most of the night. It seemed like my circadian rhythms just shifted. I still had some panic attacks in certain situations, like upper floors of buildings or places I couldn't get out of easily. During this time I was on various SSRIs and the Klonopin. It never really helped much. There does seem to be a seasonal component to it where I feel better in the summer and worse in the fall/winter.

When I was 27 I went off to school again with Effexor XR, Ambien, Klonopin and some Xanax. I ended up trying to commit suicide. I think the Effexor did something weird to me. I never thought of suicide before but it seemed to trigger the thoughts and make it a more plausible solution. Since I had recently broken up with someone and quit college when I got to the hospital for the suicide attempt I got the Borderline label as well as MDD and panic disorder I believe. Since then I have been dx'd as BPII but I am not so sure of that dx. I think I might just be depressed over panic attacks that won't remit and a life in chaos and shatters.

Three months after my suicide attempt I went off all meds except the Klonopin and the med I was taking for my thyroid. It was in the fall of last year that I did this. I went on the have the best year of my life functionally. I held my first 9-5 job ever and did well and was promoted. Come fall I started having trouble getting out of bed again and my anxiety jumped through the roof. I would be remiss not to mention that around this time I was also getting out of a relationship, moved to a new apartment, father had a heart attack, got promoted at work and found out my brother was getting divorced. So there was certainly some stress. I went to a psychotherapist and a pdoc. The pdoc put me on Lexapro and Lamictal. The combo of starting both together put me through the roof in terms of anxiety. I quit taking them. My anxiety just kept getting worse and worse. I took leave from work. I never went back. I moved back home because I was not eating and was scared to try meds out again alone after the Effexor experience. I saw a new pdoc here and he started me on Depakote ER and Seroquel and after time started Lexapro again. Here is my med combo now:
Depakote ER 1000mg
Lexapro 10mg
Klonopin 2mg
Seroquel 25mg
Levoxyl 25mcg

I have been on this combo for about 2 months (less with the Lexapro). I still don't feel right. I again feel better at night than during the day, have anxiety, at times am too depressed to do much of anything but have other days when I am more functional and basically just don't know where to go from here in terms of meds. It seems I feel worse since the Lexapro. I just feel out of it and am sleeping more. I have never really responded well to SSRIs. I don't know about the BPII dx. Why did I feel better off meds? Panic and anxiety seem to be my real problem and still are. I feel drugged up and hanging by a thread and like I am not getting the right help meds wise.

So what do I tell my pdoc? I want to streamline these meds because I just feel drugged and like I am getting more side effects than benefits. I am still anxious. And what about the BPII dx? I don't think I have ever really been hypomanic. Okay, I am getting tired of writing but I would appreciate some help on where to go with meds from here and what you all think a dx might be or what the heck is going on!! If you need more info just ask...

Thanks...


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poster:lepus thread:313724
URL: http://www.dr-bob.org/babble/20040215/msgs/313724.html