Posted by finelinebob on August 20, 2006, at 21:55:47
In reply to I am losing it-I need help, posted by Mandy on August 20, 2006, at 15:14:45
What can you do? Get a second opinion, for one.
I can see why your PDoc wouldn't want to change meds ... that's quite a balancing act. And to get to that complicated a cocktail, you must have been seeing her for quite some time and have built up a trusting relationship, something that shouldn't be set aside without careful thought.
Between Wellbutrin and Lexapro, she's got all of the big 3 neurotransmitters covered plus a high dose of a mood stabilizer and you're still depressed? Toss on top of that enough anxiety that you need a benzo and 2 sleep meds to knock you out at night? IANAP (I am not a psychopharmacologist) but I'd say there's something toxic in the first half of that equation.
I spent 2.5 years of hell getting bounced from one SSRI single therapy to SSRI + something else until my PDoc finally decided to augment zoloft with nortriptyline and BAM!, it was like night and day. He was convinced that he'd found the right "augmentor", and it took me a month or two to convince him he had it backwards. My brain doesn't have a problem with its seratonin levels, so all these seratonin meds were just plain toxic to me. Apparently, I do have a problem with norepinephrine.
I tried Wellbutrin and it made me psychotic. I'm not exaggerating ... I wound up taking perphenazine as well. I don't know the specific differences between Wellbutrin's action on dopamine compared to Ritalin and, in particular for me, Focalin ... but (dextro)methylphenidate stabilizes me where buproprion incites near-uncontrollable rage. Add in the TCA for me, and nortrip/Focalin is working on the same neurotransmitters as Wellbutrin but in different ways -- one results in a toxic, negative outcome; the other (along with 150mg Lamictal and 3mg clonazepam) produces a state of mind I can only describe as "well being".
Bottom line for me was that it took moving away from NYC for 3 years for me to break that comforable bond with someone who wasn't willing to do more fine tuning and start anew with someone who was.
Bottom line for you is whether having the reuptake of the big 3 inhibited is hurting more than helping. The status quo isn't working for you. It's your doctor's responsibility to address that. If she can't, then it becomes your responsiblity to either shake some sense into that PDoc or find one that will listen to you.
I know it will be hard. I didn't have the courage to do it myself, and let a life event make the decision for me. But we'll be here if you need support, whatever your decision is.
poster:finelinebob
thread:678493
URL: http://www.dr-bob.org/babble/20060818/msgs/678607.html