Friday, May 25, 2012

My medication story


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The first medication I took for depression and obsessive compulsive disorder was Anafranil. This was in early 1990, right after the FDA approved the drug for use in treating OCD.
My psychiatrist told me it was the first drug approved for OCD specifically. Since Anafranil is a tricyclic antidepressant, it would work on my depression too.
Anafranil did help me. It took about three months before I saw the full measure of its help.
It took away the worst of my cleaning and checking compulsions. It made it easier for me not to give in to compulsions. And it lifted me out of a deep depression.
I will be forever grateful for Anafranil and for other medications that I’ve taken since then that have helped me deal with my mental illnesses.
Janet at the blog ocdtalk inspired this post. In an excellent post called “OCD and Medication,” she wrote she thought it was important to share our stories of our experiences with medications, because medication was a sometimes controversial topic when discussing treatment for mental illnesses.
As Janet points out in her post, people have different experiences with and attitudes towards medication.

Let me preface my story by saying that I know not all medications are for all people. And what works for me may not work for someone else. Not everyone needs or should take medication. Any decision about medication should be made in conjunction with your doctor.

Medications have been quite literally a lifesaver for me. I don’t think I’m being overly dramatic when I say that I’m not sure I would be here today if I had not had the help of medication.
I have had serious bouts of depression. Long ago, I made plans to end my life. Medication combined with talk therapy kept me alive.
Anafranil was not the first medication I took. I was prescribed Prozac and took that for about a month before Anafranil became available in pharmacies.
Anafranil was not without its problems. I gained a lot of weight while I was on it.
I also eventually fell back into depression and lethargy. For the past 20 years or so, I’ve been on Zoloft, Luvox, Celexa, Buspirone, Seroquel, Abilify, Wellbutrin, Cymbalta and Klonopin, and different combinations of the drugs, for depression, OCD and anxiety.
My family doctor told me once that medications could stop working. That seems to be my story.
Some of the medications helped, some didn’t. I felt horrible on some of them. Seroquel and Cymbalta were not good for me at all. It was during a period of trying different drugs, including those, under the care of my family doctor that I developed paralyzing anxiety.
I was afraid all the time. I would lie in bed at night, whispering over and over, I’m so afraid. I couldn’t drive. I didn’t want to be around people. I faced any task with extreme anxiety.
I couldn’t concentrate enough to read or write. I felt antsy and ready to leap out of my skin.
It was one of the worst times of my life.
I don’t know for certain that the medications caused my problem, but I do believe they contributed to it.
When I finally started seeing a psychiatrist again, he just shook his head at some of the medications I had been on, saying, “You should have never been on that.”
He is treating me for OCD, depression and generalized anxiety disorder.
He started me on Lexapro, which I’m still on. It has been of tremendous help to me. I haven’t had a difficult time with side effects either.
I am on 30 mg/day of Lexapro, which is a high dose. This is a problem only when my insurance company refuses to pay for that dose, and my doctor has to send authorization showing that I really do need that amount.
My doctor said the insurance company really isn’t concerned with the dosage I’m on. They are concerned by the fact that I have to get 45 of the 20 mg pills for a 30-day supply of the medicine. In other words, they had to pay for 45 pills instead of 30 pills.
My doctor eventually added Wellbutrin. I was on 300 mg, but I asked him to cut it down to 150 mg because I believed it was making me hyper.
And he recently added just 2 mg of Abilify, which has been very helpful for the depression.
I also take a low dose of Klonopin every day. I wasn’t taking it every day, just when I thought I needed it, but the doctor told me he wanted me to take it every night, that it would help with anxiety the next day.
Years ago, another psychiatrist told me that Klonopin was good for people with OCD because it gradually went into the system, instead of giving a quick relief.
I’m also prescribed Trazodone to help me stay asleep during the night. My doctor said that it’s not addictive. I don’t take that very often, though, because even a low dose makes me feel groggy the next morning. I’m doing this with my doctor’s knowledge.
That’s a lot of medicine. But it’s a combination that works. I don’t feel drugged, sluggish or hyper like I have on some medications.
Here are some things I’ve learned along the way about medication:

*Not all medications work the same way.
*Not all selective serotonin reuptake inhibitors (SSRIs) are the same.
*Some medications work faster than others.
*Combinations of different drugs can be very helpful.
*It’s important to discuss any concerns you have about medication with your doctor.
*For me, a medication plus therapy is working the best.
*There is nothing to be ashamed of in taking medicine for mental illnesses.
*Taking medicine does not mean that you are not working hard to battle mental illness.

What are your thoughts on taking medication for depression, OCD and/or anxiety? What have your experiences with medication been like?

19 comments:

  1. This is a very informative post.

    I started out on Buspiron all by itself and it didn't do much except calm the physical symptoms of my anxiety sometimes. Then I added Lexapro and I was taking that plus the Buspiron for a while.

    I was on 30mg of Lexapro for a while but it was giving me more panic attacks so I currently take 20mg.

    I have taken Vistaril for sleep in the past but it makes me ever so groggy that I don't take it anymore.

    I have tried Seroquel, Sapharis and Geodon and hated all 3 of those.

    I am currently confused about whether or not to continue with medication. My therapist is really encouraging me to stay on the Lexapro or another SSRI at the very least.

    Sigh... I don't know what to do right now. The Lexapro does shorten the duration of my episodes so that is a good thing. Currently I am only taking Lexapro.

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    1. Elizabeth, I know it can be tough deciding what to do about medication, especially when you've had some tough expereiences. Perhaps you could write down the pros and cons of taking the Lexapro and review that with your therapist. And find out for sure why your therapist wants you to continue taking it. That might help in the decisionmaking process.

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  2. Thanks for sharing your story, Tina (and for the mention :)). Sounds like you've got a great doctor who you work well with. I'm so glad you've found the right combination of meds to help you. You are a wonderful inspiration to others because you are working toward recovery using everything available to you......the right therapy and medication.

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    1. Janet, Thank you! I do see medication as one tool, a very valuable one to me, but not the only one available to fight the disorders.

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  3. Funny how no one questions a diabetic taking insulin or me taking thyroid medicine for Hashimoto's, but with mental health, a lot of people feel the need to defend medication. I wish it weren't the case!

    I have avoided medication because my body is unusually sensitive to all medications. For some reason, I do not tolerate them well, and if there's a side effect to be had, I get it. My stepdaughter is the same way (we are oddly similar, even with no blood relationship). I responded well to CBT, while she didn't, but she has done well with DBT. It's fascinating how we're all different! I'm all for "whatever works."

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    1. Nadine, You sum it up right there: "Whatever works." I'm grateful that we have so many options nowadays to choose from in getting treatment.

      Why do we have to defend taking medication for mental health problems? Something I definitely want to explore.

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    2. I've been interested to learn though, that many people who need to take these medications (insulin, etc) are just as resistant to doing so as people with OCD are about their medications. I guess there's just something in a lot of people that resists medication, no matter how clear the need might seem from the "outside,"

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    3. Ann, That's interesting. I can see examples of that in my own life. I used to resist taking my blood pressure medicine. I just didn't want to be on that type of medication. I think I was in denial. I would go off of it without telling my doctor. When he found out about it, my doctor told me I needed to take it, that it was going to keep me alive. That gave me a different perspective!

      But I wasn't ashamed of taking blood pressure medicine. I didn't mind telling others that I took it. I guess that would be a difference.

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    4. I agree with whatever works, you have to balance the risks and benefits of anything. And as with everything else stop the judgments!

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    5. Jodi--Yep, balance the risks and benefits. And I agree--we need to stop the judgments related to taking medication!

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  4. I'm all for medication when it's truly needed, and I think the key is having a doctor that will monitor closely and help you find the right combination. There are definitely drugs that will make you worse, but a good doctor will stress that so you can contact him/her and get adjustments right away.

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    1. Lisa, You make an excellent point: it's important to have a doctor who is available to talk about adjustments, problems, concerns, etc. Some things just cannot wait until the next appointment.

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  5. I'm glad you've found a combination that works for you. It certainly can take quite a while to find the mix. Plus, I've been told that it can take up to 12 weeks to see if an SSRI is working for OCD. I believe my med started kicking in and working probably around week 10 or 11.

    I never wanted to take medication. It frightened me. My first attempts at medication were a disaster so I waited over a decade before I would consider going on medication again. Not every SSRI works the same way in the same person. This time around, I'm on the right med and I'm doing much, much better. You're right - taking medication does not mean I still don't have to work to fight OCD. It just takes the edge off of the obsessions, and it does help very much with the depression. I'm no longer ashamed to take medication, because I understand that I have an illness like any other.

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    1. Sunny, So glad the second time around with medication was much better than the first! You're right--medication takes the edge off so we can fight, fight, fight in other ways.

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  6. anafranil was one of the first drugs i took. My son who turned 13 today is taking it now.
    I have tried most of the meds you mentioned. I'm trying now to do it alone without doctor's help. Let's see

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    1. Nikky, Do you mind my asking why you are trying to go it alone? Are you able to have access to a doctor who might be more understanding? I agree that medications are not for everyone, but I hope you are getting the supportive care that you deserve! :-)

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  7. Oh my goodness, Anafranil was just the worst for me ..so happy that for you it was helpful. I know we all respond differently. I think your post is encouraging..it can be difficult to try all these med's and yet to feel better sometimes it just has to be done. I always enjoy your posts.

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    1. Thank you, Krystal, I appreciate it! Anafranil helped me, but, boy, did I gain weight, which was not a good thing. That is part of the barrier to getting to a good place with meds, I think--sometimes having to try so many. It's easy to just give up.

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  8. I find medication tricky because it can be difficult to know what's doing what - was it the medication or some other factor(s) making me tired, depressed, etc... It seems to be a very incomplete science with medication, but I definitely seek the right meds as part of treating my mental disorder. I'm on Anafranil now at 200mg and it seems to ?maybe? be helping for OCD. The effect is not obvious, so I don't consider it worthwhile staying on, but my doctor and I are looking to either increase the dosage to the maximum (250mg) and/or add Luvox (Luvox is supposed to help increase the therapeutic effects of Anafranil). I'll give it a good try and if the effect is still too subtle to notice a difference (or there is no effect), then I guess time to taper off and try another medication. Has anyone tried fast-acting benzo medication for their OCD symptoms (like Clonazepam, Ativan, Valium, Xanax, etc...). Was it helpful?

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