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 nails, which were bitten down to the quick. Although I've been biting my nails since I was a child, normally I can stop for a year or so, but it's been over seven years since I had long nails - since I started the Wellbutrin. And my husband made a point of agreeing when I told him that I thought I'd been more anxious overall since I started the Wellbutrin, so I knew that it had been (painfully) obvious to him also.
I detailed my past antidepressant history for my doctor, with the thought that this might help him choose a new medication for me. In addition to Wellbutrin I had also taken Norpramin for most of the first decade that I was on antidepressants. Norpramin is a tricylic antidepressant that had been very successful in banishing my depression, but it's a decade-old medication with side effects including dry mouth and teeth decalcification. During one year of that decade I had taken Prozac, but went back to Norpramin since the Prozac made me feel flat emotionally (although it did help my obsessive compulsive disorder).
I also talked about the depression symptoms that I had suffered in the past, as my current doctor is not the one who initially diagnosed my depression. My depression symptoms were not necessarily typical. I never had a change in my eating or sleeping patterns, for instance. Looking at the specific symptoms that a depressed individual is experiencing can help a doctor diagnose the specific type of depression. That diagnosis in turn guides the doctor toward the right antidepressant. Some antidepressants work better with atypical depression or treatment-resistant depression, for instance, than others.
My doctor suggested a medication that I had heard of, but didn't know much about, called Lamictal (generic name Lamotrigine). Lamictal started off as an anti-seizure medication for epilepsy, and was subsequently found to be effective in controlling bipolar disorder type 1, for which it was approved by the FDA in 2003. It is now being used off-label to augment other antidepressants in people with treatment-resistant depression, and is thought to be an effective antidepressant by itself. My doctor checked to see if the medication would cause problems with any of the other medications I'm currently taking, and found that it could decrease the effectiveness of my birth control pills by half! So that necessitates a call to my GP, who prescribed my birth control, to find out if I need to change to a higher dose.
One positive aspect of Lamictal, according to the literature, is the lack of side effects. When my doctor told me this, I smiled at him indulgently. I have taken very few medications that are completely lacking in side effects. This is one time I would have liked to be wrong, but unfortunately I wasn't.
I detailed my past antidepressant history for my doctor, with the thought that this might help him choose a new medication for me. In addition to Wellbutrin I had also taken Norpramin for most of the first decade that I was on antidepressants. Norpramin is a tricylic antidepressant that had been very successful in banishing my depression, but it's a decade-old medication with side effects including dry mouth and teeth decalcification. During one year of that decade I had taken Prozac, but went back to Norpramin since the Prozac made me feel flat emotionally (although it did help my obsessive compulsive disorder).
I also talked about the depression symptoms that I had suffered in the past, as my current doctor is not the one who initially diagnosed my depression. My depression symptoms were not necessarily typical. I never had a change in my eating or sleeping patterns, for instance. Looking at the specific symptoms that a depressed individual is experiencing can help a doctor diagnose the specific type of depression. That diagnosis in turn guides the doctor toward the right antidepressant. Some antidepressants work better with atypical depression or treatment-resistant depression, for instance, than others.
My doctor suggested a medication that I had heard of, but didn't know much about, called Lamictal (generic name Lamotrigine). Lamictal started off as an anti-seizure medication for epilepsy, and was subsequently found to be effective in controlling bipolar disorder type 1, for which it was approved by the FDA in 2003. It is now being used off-label to augment other antidepressants in people with treatment-resistant depression, and is thought to be an effective antidepressant by itself. My doctor checked to see if the medication would cause problems with any of the other medications I'm currently taking, and found that it could decrease the effectiveness of my birth control pills by half! So that necessitates a call to my GP, who prescribed my birth control, to find out if I need to change to a higher dose.
One positive aspect of Lamictal, according to the literature, is the lack of side effects. When my doctor told me this, I smiled at him indulgently. I have taken very few medications that are completely lacking in side effects. This is one time I would have liked to be wrong, but unfortunately I wasn't.
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