To pill or not to pill

20 Dec

So I went to my doctor yesterday and said those magical words.

“yeah, my foot hurts and I’ve been having some not so happy thoughts of the killing myself variety and I don’t think my pills are working can you help?”

I got the look that I generally get when I make that confession-the “should I be worried, can I see any cuts, does she look nuts” look. He seemed relieved that aside from being a bit wide eyed and paniced, I was none of those things. But my thoughts, they have been scaring me.

Perhaps it Christmas, since the thought is depressing me more than making me happy, what with the lack of snow and general lack of goodwill towards men around here. Or perhaps my period triggered a vast depressive swing, but I doubt that, since I was on apathy road well before that was a factor. I just can’t seem to shake it, this weight on my back that sits and pulls me ever so slightly down, keeps me from really feeling things.

I’ve spent a large amount of my life feeling this way, and I fucking hate it. You know what life is like numb? It’s like zero, like nothing. Like someone could stab you and you’d barely notice. I have no desire to return to that life.

My trileptal has done a good job of flattening out manic periods, but the depressive periods haven’t been so lucky. So the doctor, who admitted that bipolar is not his specialty, offered me Celexa.

It’s an SSRI. I’ve never wanted to be on a SSRI-some part of me panics a little bit when that word is spoken. I read all the side effects, and I worry. I don’t want to gain weight (since I NEVER get the weight LOSS side effect0 I don’t want to sleep even less than I do. I do not want the sexual side effects. Things are bad enough when I have few manic periods.

So tell me-has anyone had an experiences with SSRI’s? Anyone with bipolar tried this class of drugs? I want to know what experiences people have had with these, before I make the decision to take them.

My other option is to try and see the skrink again who originally prescribed the trileptal, IF I can get in. Or locate the profile she wrote, which had options written on it for treatment.

I hate trying new drugs. I hate the thought of ruining my body and marriage any further even more.

25 Responses to “To pill or not to pill”

  1. liprap December 20, 2006 at 9:29 am #

    A good friend of mine has been on nearly every SSRI that has been made, and the side effects with every one did her in. She is on lithium, the dosage of which is constantly monitored…and her mental state is monitored as well by a good psychiatrist.

    I’m on an SSRI myself, but I’m not bipolar. I do believe in that good combination of counseling and meds, if things are really bad. It just helps to be able to talk about it with the right human being.

    Of course, finding the right human is the trick…

  2. Heather December 20, 2006 at 9:46 am #

    I’ve taken three different SSRI’s. Paxil, which turned me into a numb zombie, made me eat constantly and thus gain weight, and stole my ability to orgasm at all.

    Zoloft, which actually gave me the weight loss side effect, I loved it, but couldn’t afford to stay on it (this was before there was a generic) because my prescription insurance is reimbursement only – being out $100 every month just was not in the budget. I would say I had slight sexual side effects but could definately still orgasm. I felt energized otherwise. Zoloft and my body chemistry worked very well.

    I went on generic Prozac when I found out the price of the Zoloft. I’d say the Prozac kept me on an OK, even keel. It wasn’t great, it wasn’t bad. No side effects to speak of. Helped the depression, but not the anxiety.

    Right now I take St. John’s Wort and Fish Oil, and go to therapy every 2 weeks. It seems to be working for me. I don’t know if the natural stuff is an option with anything else you’re on, though. I know SJW and hormonal birth control don’t mix.

  3. notsopregnantintexas December 20, 2006 at 10:51 am #

    Another SSRI user over here. I’ve been on Zoloft for the last three years and it’s worked well for me. I haven’t had the weight loss side effect and any weight gain was my own doing.

    I actually took it for my entire pregnancy, going from 100mg in the first two trimesters, down to just 25mg every other day in my last trimester. When people tell me that my son is such a happy baby, I kind of smile to myself and think it’s because he had a happy (read: medicated) Mommy.

    I would stay away from Valium or Paxil. Both of those medications have known sexual side effects. Wellbutrin might work well for you, but I agree that the combination of meds and therapy is really effective.

  4. thordora December 20, 2006 at 10:56 am #

    Paxil is evil. I tried it for about 2 weeks once, and threw them out. I could have rubbed up against the biggest dildo ever, with no effect. That SUCKED.

    I’m worried mostly because the reading I’ve been doing states that even after coming off the SSRI you may not regain full sexual function.

    Therapy for me had hit an impass-I wasn’t gaining anything new from it-I’m fine when my moods aren’t stupid.

  5. Jason Dufair December 20, 2006 at 11:48 am #

    I’ve had 3 or 4 acute depressive episodes and Prozac has helped for the last 2 (didn’t treat the first ones). Didn’t help with anxiety – in fact it made me clench my jaw. Didn’t make me gain weight, but did get me to eat again (I don’t eat when I’m depressed). Definitely lifted the depression. No sexual side effects of note. I don’t think they make a drug that could slow down my libido though 🙂

    If the doctor’s specialty isn’t bipolar, shouldn’t you find someone who does specialize in bipolar?

  6. katsplace December 20, 2006 at 12:23 pm #

    Thordora, could you call the psychiatrist’s office and see if you could get a copy of profile she wrote? It may be that it was also kept on file in the office. If not, I would call the Psychiatrist and explain what was going on in detail. They might consider it something that warrants an earlier appt rather than making you wait.

    Years ago now, I took Paxil for a short while. Mine was a combo of situational depression and PMDD. Mine also had a strong component of Anxiety to it – probably more than the depression. I didn’t like being on it but it did help me get through that hurdle.

    My mom has taken Celexa for years now. She deals with chronic nerve pain from her spine. Her primary suggested it early on. She, I believe, likes it but she’s also 74 and a serious prude.

  7. Heather December 20, 2006 at 12:32 pm #

    I took Paxil for 6 months – and honestly, I’m not sure I ever have recovered my full sexual function as far as general horniness goes.

  8. puddlejumper December 20, 2006 at 12:56 pm #

    Hey thordora, sorry you’re feeling so shit.

    Big coincidence reading your post today. I’ve been on Citalopram (celexa) for past 5 months and me and the husband had a big chat last night about the “sexual” side effects.

    I hate to say it but it’s almost removed my libido entirely. And I’ve always prided myself on being quite a horny little minx. It’s doing my head in.

    For myself, I actually don’t miss it but I feel like shit for my husband. He’s a gorgeous hot blooded man and I love the bones off him. But these days I’d rather read a book. And that is soooooo not me.

    Without wanting to be too crude (but we’re all friends here right?) I’m not even interested in being sexual “on my own” just now.

    Granted I no longer want to throw myself on a train, I’m thinking clearer and as far as other side effects I had no problem other than a bit of nausea the first couple of days. But it scares me to think “is this it?” no more sexual urges?

    I’ve been trying not to think about it just now and enjoy the period of stability. But the comments above about it perhaps being permenant scare the crap out of me.

    Is it honestly a choice between staying sane and having a sex life?

    I’m not sure I want to give it up for good at 32. I’m pretty certain my husband doesn’t deserve that either.

    I have experience of Prozac too. Funnily enough (in addition to the absolute inability to orgasm, though at least I still wanted to) it also made me grind my teeth at night. My doc at the time had never heard of that as a side effect.

    My lows have always been far worse than my highs and I know you need to watch if you are prone to mania on SSRI’s. Although it’s stabilised my sleep, I sleep less now and the first time they upped my dose I was hyper (and ironically horny) for about four days.

    I would have to agree about trying to find a specialist too.

    Maybe it’s just the stress of Christmas and you’ll feel better yourself once thats all by?

    You know where I am if you ever need someone to rant to.

    x

  9. feartheseeds December 20, 2006 at 2:03 pm #

    If you’re nervous about an SSRI try something like Wellbutrin instead. SSRI’s have side effects, just like every other pill. If you don’t like them, change pills. There’s nothing saying you’re stuck on one pill for the rest of your life. It is important to keep track, however. Find out what the side effects are, and keep a notebook on how you’re feeling.

    Trileptal is in the same category as Lamotrigine, it’s an anti-convulsent used mostly in epileptics but now being prescribed (at different doses) as a mood stabilizer. Personally, if Lithium works for you I’d go with the Lithium. The idea of a stabilizer is to put limits on our Mania’s and Depressions. If you’re still finding deep valleys, the pill is not doing its job.
    If your doctor doesn’t understand Manic Depressives, ask him to refer you to someone who does. Your life is worth more than any risk of hurting his feelings.

    “My other option is to try and see the skrink again who originally prescribed the trileptal”
    Walk, don’t run, into your local emergency room and tell the doctor the drugs you’re on aren’t working and suicide is a possibility. They will admit you. They will ask you who your doctor is, they will call the doctor who prescribed your medication to you.

    “I hate the thought of ruining my body and marriage any further even more…”
    Your health, your survival comes first. We have to make every effort to put our own health and sanity before everything else. Find the drug combination that works best for you and move forward. Every day you’re improperly medicated is another day where the Disease could convince you there’s nothing worth moving forward for.

    Go here, read these:

    http://saltedlithium.wordpress.com/2006/11/28/lucid/

    http://saltedlithium.wordpress.com/2006/11/22/finding-rivers/

    http://saltedlithium.wordpress.com/2006/12/16/you_will_not_die_this_holiday_season/

    Keep fighting.

  10. feartheseeds December 20, 2006 at 2:15 pm #

    re: Puddlejumper & Sex

    The ‘urges’ are never the same once the manic’s are under control. Depending on the medications you’re taking the dose can be altered so that the urges come back, but, again, medications can be changed. Once you’ve found one or more medications that offer you some clarity, allow yourself to recover for a while. When you’re comfortable with who you are, modify the dose to allow for your libido to bounce back to a normal level. Having sex eight or nine times a day will never happen again as long as the disease is under control. But three or six times a week is still entirely possible. Just get comfortable with the non-manic, non-suicidal You first. Then worry about the monkey lovin’. If you’re still having problems, try listening to Leonard Cohen. Everyone has sex when they’re listening to Leonard Cohen.

  11. Kimberly December 20, 2006 at 6:34 pm #

    I’ve been on Celexa Thor. It’s one of the newer SSRIs and doesn’t really have a lot of the bad side effects. I mean, I’m sure some people have a bit, but it’s not brutal. The sexual part is almost nil. Sleep gets disrupted then you get used to it and it evens out, and I didn’t notice any weight gain.

    What I did find was that there wasn’t enough hours of the day to contain the happy. I hadn’t realized there was that much happiness in the world. And for the first time, I really understood what Sylvia Plath meant about the Bell Jar lifting.

    (As a side effect, I noticed the last time that I was on that it was an overall leveller–the mania died down on it too.)

  12. Carin December 20, 2006 at 8:51 pm #

    so the sleep-disruptions get better too? I have a friend who just went on it and she says her sleep’s been fucked. How long should she let the sleep-disruption go on before she says, hey doc, my sleep’s fucked. I mean, do people find this side-effect dies down too?

  13. thordora December 20, 2006 at 9:18 pm #

    Sex and weight gain are my biggest fears. So we’ll see. Frankly, screwing with those will put me right back where i was, so I don’t see the point.

    I’m going to dig up the profile and see what it says.

    But it’s only a month. I could try it, right?

    I’m going to ride out this week, and see if it gets better. today was ok.

  14. feartheseeds December 20, 2006 at 9:30 pm #

    “so the sleep-disruptions get better too?”
    Sometimes. I have a friend on an SSRI who smokes half a J. before bed, puts him out like a light. I’ve been taking 100mgs of Seroquel for 2.5 years so I can sleep, but that’s mostly to fight the Night Manics (endless replaying of events in my mind), not disruptions specifically.

    Your friend should talk to her doctor as soon as she decides the disruptions are a pain in the ass. It should be considered the BiPolar Golden Rule: “as soon as you realize something’s wrong, talk to your doctor about it”.

    When I first started taking Wellbutrin I was up three times a night (sometimes I’d wake up standing on things, like my coffee table… WTF?!?), but the Seroquel is giving me eight hours of blissful sleep a night for the first time in eighteen years.

    Get your friend to talk to her doctor… bring a list of questions, get them answered and take notes. None of us need to be suffering in silence while so many treatments are available.

  15. feartheseeds December 20, 2006 at 9:38 pm #

    “Sex and weight gain are my biggest fears.”

    Like I just suggested to Puddle somewhere else, basically the choice, in the short term, is sex or suicide fantasies. There’s no rush, take your time, allow yourself to find out the difference between the Manic Depressive You and the non-diseased You. Live for a while without suicide being your primary thought. The sex comes back, just not as Manic, and the more comfortable you become with who you are, the better the sex gets.

  16. Southerncharm December 20, 2006 at 9:52 pm #

    I’ve been on Wellbutrin and it turned me into a monster. I wanted to hurt anybody that came with in 10 feet of me! I had to stop. I have taken Zoloft and other than the side effect of going to the bathroom several times a day for about 2 weeks it seemd to work for awhile. I was on 100mg, about 2months later it seemed to have no effect on me and I seemed to down slide. I just stop taking all meds and tough it out. I know that is not possible for most people and not healthy, but thats what I have been doing for the past year. Good luck on finding the right cocktail. I’m sure its out there.

  17. Anonymous Cog December 20, 2006 at 9:53 pm #

    Hi Thordora,

    Just stopping by to wish you a Merry Christmas.

    AC

  18. kassie December 20, 2006 at 10:39 pm #

    Hello. I work for a board certified psychiatric MD who specializes in the medication piece. He takes referrals from Primary Physicians and his primary job is to monitor medication trials for patients. I would suggest a Psychiatric MD who can monitor you every few weeks if you are concerned especially with such important possible side effects. That way you can hopefully head off any bullshit and try something else if it isnt working. You should try someone that specializes in psych meds. I Hope your Holiday Season gets better.

  19. Tortugita December 21, 2006 at 2:26 am #

    I’ve been on Zoloft (sertraline) for four years now and it pretty much saved my life.
    I do have two problems with it though. (Neither of which are related to weight or sex.) Because I’ve been on this particular drug for so long, I’ve started developing a mild tolerance for it. I started out on about 75 mg and am now on 300mg. This wouldn’t be a problem except that I’m slowly approaching maximum dosage for it and will eventually have to either find something new or get weaned off of this one. Which brings me to my second issue. Serotonin withdrawals.
    Holy fuck does that suck.
    You mentioned earlier that you weren’t so great about taking your birth control pills. That can’t go on when you’re on an SSRI. It’s important that you take your meds. every. day. There have been at least two occasions where I’ve missed more than two/three days of my meds and I completely crashed. One of those times I ended up involuntarily committed. That was pretty shitty.
    That’s not to say that you shouldn’t not take them though. Like I said, zoloft pretty much saved my life and I’m still using it four years later so it did something right. I’ve had no long-term side effects at all. It didn’t affect my weight and I’m still fully capable of having an orgasm. I would have quit if it had screwed with either of those aspects of my life.
    I know how hard (and scary) this kind of decision is. I flat out refused to take zoloft for a good three months before I finally agreed to give it a go. It was definitely worth it for me, though.

  20. heidi December 21, 2006 at 12:14 pm #

    Looks like you’re covered on the advice front… but my experience with Celexa/Lexapro was very positive. No side effects at all and no major depressive symptoms, and this was during my mom’s illness and death, so I had the most situational influences of my life.

    However, I’m not bipolar, just mildly to moderately depressed and it’s actually been fine untreated for several years, so my experience isn’t uch help except to say the side effects weren’t a problem.

    Let me know if you ever need a virtual ear or shoulder. Your comments on my “Colleen” post were very tender and made me all gushy and wanting to cuddle you. Feel better- Gods!!! the holidays suck when you’re feeling the ick. They’ll be over soon. Lots of love, h

  21. thordora December 21, 2006 at 2:53 pm #

    I’ve really appreciated everyone’s feedback and advice with this.

    One of the main reasons I resisted treatment or even seeing someone for so long was due to the possibility of meds. First I was diagnosed with ADD, and on Ritalin for awhile. Then someone tried me on Pail (EEK!) and Seroquel (nu-uh-on half of a pill knocked me out for 14 hours dead. That shit scared me). Now we’re here.

    I call the manic me “ME”, and I kinda miss her. She has a sense of humour and stuff. But somedays, I just don’t know where or who ME really is, and that sucks the most.

  22. feartheseeds December 21, 2006 at 4:24 pm #

    Southerncharm: “I’ve been on Wellbutrin and it turned me into a monster. I wanted to hurt anybody that came with in 10 feet of me! I had to stop.”

    I was the same way at first… my doctor started me at 300mgs/day, but after I destroyed three PlayStation controllers, three or four games and the bathroom door, he lowered the dose to 150mgs. I’ve never had those Rage Attacks since.

    I’ve only ever used the 100mgs of Seroquel as a sleep aid… except in the beginning when I thought it’d be okay to double dose after I had missed a pill. I was a stumbling idiot. Imagine being a schizophrenic and being prescribed a thousand mgs of Seroquel. Those poor bastards… they’re not treated, they’re tranqualized into a stupor then locked in a room.

  23. Kimberly December 22, 2006 at 3:23 pm #

    I hear you about the manic you being the real YOU, Thor. I feel that way too. It’s hard to let her go. I miss that smart, funny, wild woman I was. But….I don’t miss the downside. Plus, I’m slowly getting back to a place where I can be that woman in a *healthy* way. A way that doesn’t scare my kids or make it so I can’t sleep at night without my own personal scary mantra.

    I’m slowing coming to know that the manic me is real any more than the depressed person is. The real me is somewhere between the two poles. The drugs just gave me a chance to slow down, look at the map, and find her.

  24. krista December 23, 2006 at 3:56 pm #

    I was on Effxor XR when we worked together. I actualy weaned myself about Feb 2004. It took 3 mths and I was a space Cadette for the process. It is not as easy as the labeling says to wean. Not by a long shot. I recommend trying one, but in the absloute lowest amount possible. It did wat it was suppose to when I needed, but coming of it 12 mths later was a BITCH! I did drop 25 pounds and was still horney enough to kee both of us content. If I ever get to that “place” again I’d medicate again. It was a saniety saver me and my marriage. just my $.02

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