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Treatment Resistant Depression: My Antidepressant Saga Continues

I had my quarterly appointment with my psychiatrist the other day. As planned, I told him that I would like to switch to a new antidepressant. I felt that Wellbutrin, which I had been taking since 2000, was exacerbating my overall anxiety level. I showed him my nai...
Anonymous
Leora
2/27/08 6:28pm

I've done Lamictal.  I had too many side effects from it (dryness, itchiness, headaches from sun).  I was so glad to get off that one.  Now I've been on Lexapro for 1.5 years; it makes one very tired for the first few weeks, but my body is used to it by now.  Still some dry mouth.  Some weird feelings I attribute to the meds, but my psychiatrist does not.  But at least my moods have been stable.

 

A friend who was on Lexapro said it made her too tired.  She switched to yet another one.  I was taken off Wellbutrin a while back because of the anxiety-inducing nature of it you described.

3/ 1/08 1:43pm
I too have been a nailbiter since childhood. I was taking prozac because i don't eat on it not much anyway. I'm thrilled to fit in a size 8 again. My doc has me on Lexapro and klonopin. The Lexapro isnt doing anything as far as I can tell but the prozac runs my blood pressure way up. Did stop biting my nails for awhile but now it's a struggle again.
3/ 1/08 3:30pm

Hi Deborah,

 

There is one very big side effect for Lamictal--The Rash.  It should be in the literature??  I got it so I'm allergic to it.  My Pdoc had such high hopes for Lamictal.  It was prescribed for my Bipolar II symptoms.  Must be an all-around drug.

 

Good luck, take care of yourself.

Anonymous
Barbara
3/ 2/08 10:39pm

I am presently taking lamictal to augment my anti-depressant. When my doctor first put me on lamictal he said we have to start very low and slowly increase the dosage. he said one side effect of raising it too quickly was, take a guess - a bad rash! You may want to talk to your doctor. You may not be allergic to it. maybe the dose was started too high or raised too quickly.  I hope this helps. Good Luck.Big Smile

Barbara

4/22/11 4:09pm

exactly the same thing my doctor said.  I did not experience the rash because I was weened into the correct Lamictal dose and slowly weened off Depakote.

Anonymous
Deb Johnson
3/ 1/08 3:49pm

 

Yes, a person does have to be extremely patient when it comes to getting "just the right" medication that outway the side effects to be worth taking them for the depression!  I know as I have been going through this for the last 20 years.  It is always scarey for me when I go through a med change, as I don't know if the side effects will be too cumbersome or I will sink back in depression in the meantime.

But I have found that most of the new antidepressants mostly have a positive effect for me that outweighs the side effects.  It's a tough world sometimes ~ this business they call DEPRESSION!!!

Anonymous
Ellen Mosier
3/ 1/08 11:50pm

Hi Deborah,

I took Wellbutrin for about a year at one point. I didn't have a single good night's sleep during that time. I had bizarre dreams at first, and then I felt like I didn't dream at all. I was glad to get off of it.

 

Re sleepiness, when I started on Effexor, I was falling asleep constantly for about a month, but then it lifted.  I have been on this med now for about 12 years  (!!!!!!)  now in the "XR" version.

 

This last year my new shrink added clonazepam for severe chronic anxiety. I take it at night and have been sleeping better than I have for many years.  I wonder how much is the drug and how much is getting restful sleep that has cut my anxiety down. 

 

I am 51 now.  The first episode of depression and anxiety & fear I remember is when I was 5.  I did not get medication until I was 36.

 

Good luck with the new meds, Deborah.

Ellen

3/ 4/08 7:15pm
It's been so long since I started Wellbutrin that I can't remember how it affected my dreams or sleep, but oddly, I have been having very weird dreams since I started the Lamictal. Not vivid enough to remember any detail when I woke up, but I know they've been weirder than usual.
3/ 2/08 3:11am

Hi Deborah,

Do you really have to add birth control pills to this combination? Many years ago a pdoc told me not to fiddle around with my hormones if possible, because it would aggrevate my depression. My ex husband and now my partner had vasectomies....something for which I was eternally grateful. I don't know your situation as far as wanting children goes but if I didn't have to add something to the cocktail I wouldn't. A vasectomy is all over in a lunchtime! Not too much recovery.Phew what a relief never having to be worried about the unexpected from taking antibiotics or having a vomiting bug, or combining with other medications! Good luck with your new med, anxiety is not much fun and was a primary symptom of my depression. I took four different meds until I found the right one. I have been so lucky that Zoloft works so well for me. Best wishes R

3/ 4/08 7:11pm

Actually, when I talked to my GP last week, he asked if I would consider an IUD. I actually took it a step further and asked myself (and my husband) if I should get my tubes tied.

 

I'm not sure why it didn't occur to me before. I'm 45 and have MS. I adore my son, and would love to have had more if I was able, but my childbearing is definitely in the past.

 

I definitely would like to eliminate one medicine from the repertoire.

Anonymous
Diana Hawbaker
3/ 2/08 9:39am

Hi Deborah,

 

I'm glad to know that someone else already mentioned what I am about to mention -- the rash. I had never been allergic to any medication before my doctor asked me to try Lamictal. I didn't have any problems the first 2 weeks when I was on an extremely low dosage; however as soon as I increased the dosage I got "the rash" which is painful and very nasty. Now I have to tell all doctors, hospitals, etc., that I have Steven Johnson Syndrome -- check it out on the internet and you will see that it is a very dangerous flesh-eating condition that can affect children to the elderly.

 

Another problem is that most medical professionals do not know what SJS is and need to research it after I tell them that I have it. So Lamictal DEFINITELY needs to list SJS as one of the possible side effects -- there has yet to be a medication that I have been put on that does not have side effects.

 

This is my very first post, but I felt it was so important to let you and others know that I needed to do it.

Anonymous
Barbara
3/ 2/08 10:47pm
I have never heard of SJS before. I will have to check into it. Many people who get a rash with Lamictal believe they are allergic. Truth is a rash is one of the side effects of too high a dose OR raising the dose too quickly before the body can adjust. So many people are misdiagnosed because their doctors do not know or read the medical literature on this drug. Seek another opinion for your own peace of mind.Big Smile
4/22/08 12:02am

Here's the interesting thing. When I told my doctor that I had noticed some acne when I started Lamictal, he said that I definitely should have called him. I assumed that a rash is a rash, but apparently in this case acne is also considered something to watch.

3/ 4/08 7:18pm
I'm not supposed to see my doctor till March 20th, but I just called and left a message asking if I can see him earlier. I'm concerned about how dry my mouth is. My teeth are already decalcified from nine years of dry mouth on Norpramin, and I don't want to make them worse.
Anonymous
Sharon
3/27/08 9:21am

I know I'm coming to this discussion late, but I have a few things to add. First, my understanding is that birth control pills make Lamictal less effective, but not the other way around.  An important distinction.  Second, the Lamictal packaging definitely warns about the rashes, which are NOT an allergic reaction.  I find it hard to believe doctors aren't informed about it.  In fact, I suspect they are withholding the info from patients so as not to scare them, which is unconscionable.  All anticonvulsants (which is what Lamictal is) can cause rashes, including SJS.  Lamictal is the worst in this regard.

 

I've been taking Lamictal since December, gradually upping the dosage.  It's been added to my Cymbalta to help with my chronic dysthymia (though I'd call it treatment-resistant depression).  So far, no rashes and no side effects that I can pin to it.  You should be aware, though, that it can cause eye strain and hair loss.  My mood seemed to improve for a week or two, but now I'm not so sure.   

4/22/11 4:33pm

As with any medication, it depends on the individual as to what works and what doesn't.

 

My doctor has worked with me to find the right "cocktail" of meds to help both my depression & general anxiety disorders.  I have been on Paxil, xanax, Effexor and Clonazepam before.  But now I take a combination of zoloft, welbutrin, buspar & lamictal. 

 

We tried the depakote and now lamictal to help "stabilize my moods" because I either slept a lot or couldn't sleep without taking trazadone at night.  But I didn't like the trazadone because I was very groggy the next day.  Now, I am able to sleep without medicine.  The added benefit for me is that Lamictal is also known to help prevent/reduce the severity of migranes and it has done that for me.

 

I find that until I take the Welburtin each morning, I cannot wake up at all. I think taking it in the morning helps so that at the end of the day, it has "worn off" and doesn't keep me up.

 

I too was afraid to try new medicines.  When I was hospitalized several years ago, I was taking 325 mg of Effexor when admitted. My then current psychiatrist's response was to keep upping the dose instead for trying something new. The doctor on intake made the comment that this was way too high a dose and it was decreased substanitally the next morning.  I couldn't understand it.  If 325 mg wasn't working, why would decreasing it help?  But, in truth, I did feel much better on the lower dose.  It was after my release that I realized that I needed to switch doctors.  I found my current psychiatrist and he has been the best doctor I've had by far.  Not only is he willing to listen but he also explains the side effects before we try new medicines and answers any questions I have.  This was a first for me.

 

It sounds like you have found a doctor that is willing to listen to you which is most important.  As scary as trying a new medicine is, it may be the best thing for you.  Also, whenever we've changed my medicine, my appointments have been changed to every month and then every other month until now I am up to every 3 months.  Of course, I can always call my doctor in the meantime, if I need to.  I think that is key too because you can address any concerns and your doctor can check your progress on the new meds/different dosages on a timely basis. 

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