Input Needed ASAP

[GraceB]

Hello all,

I am looking for different areas on the web where medications pertaining to depression, bipolar, anxiety are discussed thoroughly. I am a little frustrated because I was trying to access www.crazymeds.us and cannot see any of their forum posts.

My doctor wants to see me again at 1pm tomorrow. She will most likely be putting me on either another SNRI or an SSRI. The one that I just tried that nearly sent me to hospital was Cymbalta. (A friend suggested continuing to take them might be a way I could actually find a psychiatrist who would want to talk to me. I stopped them however.)

I guess I know quite a bit, but I am wanting to enter my doctor's appt tomorrow armed with as much information as I can help her with. It is my GP I am seeing tomorrow. She is taking my case quite seriously and doesn't want me to wait before I get back on some treatment. I didn't have any real withdrawal symptoms from the Cymbalta unless what I experienced itself was a withdrawal symptom. It happened about 12 hours after I took the medication.

[GraceB]

Unfortunately unable still to access those forums. Here is what I am learning. I am trying to get all this research done by 1pm tomorrow.

Apparently, if family members are being treated successfully for similiar conditions, there is supposed to be a higher chance that those same medications may work for an individual. So, I guess, I am starting there.

Thanks all.

[AJ]

Please forgive me if you've said so elsewhere. How long were you on Cymbalta? What was your reaction? Was there anything in particular you were trying to get information about?

[GraceB]

I think my doctor is going to change my prescription tomorrow and not sure if I can be a participant in somehow coming up with what is good to try to start off with.

I only took one pill. I am historically pretty sensitive to medicine (even tylonel, etc.)

When I took the med, my frame of mind was just 'okay let's try this and be open to see what happens'. I did get nausea and dizziness which were not of much concern to me because I expected those types of side effects.

The problem is, about 12 hours after I took the Cymbalta, after being in a pretty deep sleep for 2 hours, I suddenly woke up, ripped from my sleep, with suicidal ideation, and I thought I was going to die, and I was crying out to God in desperation. My mind raced to thoughts of me being in the hospital, which I have never been for mental health, but I started imagining myself there, and was also concerned about financial things that I haven't taken care of, which I wouldn't be able to do from the hospital. I honestly thought that I was headed in that direction, and I also remembered where I had put the # for the mobile crisis unit.

I settled down, and was able to fall back asleep. I didn't get much sleep that night as I kept waking up, but none of the symptoms were as bad as the one that ripped me from sleep at about 3am Friday morning. The next several hours I just felt dizzy and nautious and had a hard time standing up for any length of time. About 24 hours after taking the medication, I was okay, and able to move about and drive.

The nurse at my doctor's office advised that I stop the medication until my doctor was consulted. I am seeing my GP tomorrow at 1pm to further discuss treatment options. That's why I'm posting, I don't know if there are things I should know before going back into that appt.

PS: It is also important to note that I have not been and do not regularly struggle with "suicidal ideation", this is a symptom that I used to struggle with 8+ years ago (and did for many, many years), but that I really haven't been struggling with since I poured myself into my church about 8 years ago.

[paul m]

Hello GraceB. Unfortunately nearly all modern anti depressants have some risk of increasing the chance of suicide in the begining. The following is from the drug product monograph of cipralex(an SSRI) that is filed with health Cda.

"There are clinical trials and post-marketing reports with SSRIs and other newer
antidepressants, in both pediatrics and adults, of severe agitation-type adverse events
coupled with self-harm and harm to others." It goes on to mention increased suicidal ideation etc etc

I could also print out the same for any SSRI, SNRI etc medication. I don't have any great advice to give you, other than to be very careful and be ready to quit taking the meds at any time( but you already knew that).

I usually use Health Cda drug product data base: http://www.hc-sc.gc.ca/dhp-mps/prodp.../index-eng.php or http://www.drugs.com/ for my research. Depending on what I or others say here on the forum can be a dangerous thing as everybodies reaction to meds is different.

In regards to what works within families. I hadn't heard that before, but it certainly wouldn't hurt to ask relatives. My son and I both have the same illness, but we both react to our meds differently. What works for him, doesn't work for me. Take Care. paul m

[AJ]

Grace that sounds like an awful experience.

I have to agree with Paul. Everyone is different and what works and is tolerated by one, may not work or be tolerated by another.

There are a lot of meds out there for varies forms of mental illness. It is a tall order to be familiar with all of them, but I do find becoming familiar with the general information of a class of drugs a good place to start. Eg typical or atypical antipsychotics. Antidepressant classes such as SSRI, SNRI among others. Once you learn the general characteristics of a class of drugs, you can learn some of the differences of individual drugs in those classes. It may not be helpful for you to approach it in this manner, but it was for me.

[GraceB]

Thank you guys. I so appreciate you responding.

I have probably done as much pre-research as I can. I don't know what my doctor will say tomorrow, but at least I can go with some homework done. She is concerned about treating the immediate anxiety and depression and everyone is concerned with helping me get back on my feet again. I am fortunate in that I can hold down a job and generally excell. But I am more aware than ever now that I actually require certain things from my environment. Structure and predictability are two that are important to me. As is a supportive environment with managed levels of stress. This year has been really, really hard and the last little while has been even worse. But, in all this, I am doing positive things that will affect the rest of my life, as well.

This is a very cyclical, chronic and severe thing that affects my life, and honestly, I hope that once I am somewhat back on my feet again that I will be able to find a therapist or psychologist that I can talk to about all of it. Because one of the pains I deal with is feeling like something is wrong or different and not knowing what it is. And it is hard to find the proper treatment if you don't know what you're treating.

[astronaut]

I hate to say it, GraceB, but it is hard to find the proper treatment even if you DO know what you're treating. I think it would be a great idea to see what the GP can do about getting you hooked up with a therapist of some sort, even if you have to go on a waiting list. You may as well start now.

As for meds, they work differently for everyone and cause different side effects for everyone. The problem is that no one really understands exactly how and why they work for some people and not for other people. It is in no way an exact science. You are very fortunate to have a doctor that is so devoted to helping you and that is taking your case seriously. Keep being honest and open with her about your symptoms and worries and hopefully that will help her in treating you and it will help you in remaining comfortable talking openly with her.

I read in your other post that your grandmother is helping you out and that you even went to church. That is great news. It can be so hard for people to reach out to others when they are feeling depressed, even when reaching out is what they need to do the most.

As for your reaction to the anti-depressant, I find that rather surprising that you had such a strong reaction after taking one pill. Did she start you at a high dose or something? I have often had acute responses to anti-psychotic and mood stabilizer drugs but never to anti-depressants as they usually tend to take longer to build up in the system and have an effect. Keep noting what kinds of changes you are having when you start your next drug so that you can continue to trace its effects. Ask your doctor if she has a mood chart that you can fill out daily to keep a record of hours slept, meds taken, mood patterns, etc.

good luck with your appointment today. That is amazing that she is getting you in so fast.

astronaut

[GraceB]

Thank you. I am blessed to have her. I am seeing her again next week as well. She reminded me again today to call Catholic Family Services Ottawa and see if they can help me.

I don't think she started me on a high dose, I don't know, she's been very careful.

She got the results from the Royal Ottawa interview I had a couple of years ago. Apparently it wasn't completely filled out. It did say "Further Evaluation Necessary". So it was inconclusive, but I guess, I could have followed up. I just felt so dejected at the time.

Anyway, we both agree that if necessary she will refer me to a different psychiatrist, she mentioned it briefly today.

What I have read about Cymbalta is that it is highly potent. Maybe that's why? It is apparently known for it's potency. I really don't know. It also had some positive side effects as well.

We are trying Seroquel XR at 50mg, so I know I may sleep a lot. She partly wants to make sure I do sleep. And she introduced the idea of maybe needing to have a couple of medications. I am sure this can get bloody expensive. Cipralex was another medicine we discussed. Does anyone have any experience with Trillium? Apparently it will cover Cipralex if I can get it approved. Anyway, yeah, this could take a while to figure out. ^_^

[astronaut]

I've had experience with Trillium. They hardly covered any of my psych meds. It was super irritating and I got really angry about it sometimes.

If I were you, I would pay for private health insurance and get it NOW. Get it before you have an official diagnosis of some sort. Once you are diagnosed with a chronic illness, say goodbye to ever being able to purchase private heath insurance. They won't take you on if they think you will be a liability. Although because your doctor has documented mood issues for a long time for you it might already be too late.

[GraceB]

I just wanted to report, no weird side effects (yet) yay!

I did sleep better than I have in a long time and I caught myself "tripping" on my partly glowing light last night. But nothing I could consider really "weird"!

I can't afford to even look at private health insurance right now. Hopefully in the next month or two maybe I could look at it.

[uni]

Hello Grace. I'm glad that your first night on the new med went well; hopefully it will continue that way. Btw do I have things screwy or did you see your doctor on a Sunday? And if so, how did you manage that?

[GraceB]

Yes, I saw my doc on a Sunday. Where she works is a clinic with several different doctors and from time to time (maybe once a week or so), they need to man the open clinic. I guess her turn fell yesterday.

With the Seroquel I am actually more concerned about how it may affect my heart right now than anything else. I have a low waking heart rate at about 45 bpm. I exercise up to 15-18 hours per week during the spring and summer. So yeah. Anyway, right now I can't worry too long term until I deal with the short term needs, I guess.

[GraceB]

Well, I didn't have a lot of energy today, but what I did have I put into physical exercise. I just returned from walking /jogging 6k in about an hour. I have to keep reminding myself that I am basically coming off of bed rest for the past 3 weeks or so.

[paul m]

Hello GraceB. Seroquel is a bit of a wierd medication. At low doses (50mg is low) it acts more like a sleeping pill than an antipsychotic. That is fine, but some people do find that this is only a short term solution, for others it works just fine over a long period.

Occasionally I use seroquel to regulate my sleeping patterns. I find that only very small amounts of it are needed to make me sleepy. I prefer the 25 mg tablet as it is not the XR variety. That means that I can split it, which puts less into my system, makes me less groogy in the morning and is cheaper as well.

In regards to Trillium. Overall the system doesn't work too bad for medications that are covered. There is a cost. They have a forumla, but basically you can just click on the link below and scroll down to a bit below page 22 and look up your 2011 income and it will tell you what you have to pay annually. This is charged to you in 4 quarterly installments if you use the plan(you pay nothing if you don't use it). How it works is, if your annual deductable is $500, you have to pay the first $125 each quarter after that you pay $2.00 per prescription.

They also have a program for people's whose income dropped a lot from last year and one for people who start part way through Trilliums standard yr(aug1st to july31)Take Care. paul m

Trillium Guidelines: http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetFileAttach/014-S46850E-87~15/$File/TrilliumBookE.pdf

You can see if a drug is listed by goin to: http://www.health.gov.on.ca/en/publi...gs/funded.aspx and then clicking on the link listed under Ontario Drug Benefit (ODB) Program and called e-Formulary database.