I have a p-doc appointment next week. I do not want to tell him that I intentionally discontinued Geodon because I need to be med compliant for the court case. I want to suggest to him that we try me without Geodon and I want him to go along with my plan. I also want him to prescribe Wellbutrin in place of Prozac because I gained weight on Zyprexa and Wellbutrin might help me lose it again. Finally, I am out of Zyprexa and want a PRN prescription for emergency sleep, either Zyprexa or Seroquel. I also want him to see my neuropsych report. Finally, I need to tell him that Topamax did not work out for me.

That is a whole lot to ask during one appointment.

Here is my plan, and I will probably fax it to him because that would be more organized (he has read my faxed letters in the past). Does it sound convincing?

-- When I went to Moscow, I used Zyprexa 10 - 15 mg to force sleep on the plane and to overcome the jet lag. Both ways - back and forth. It worked beautifully. It was my best trip, in terms of the ease of switching time zones. Zyprexa is not in my chart because I had leftovers from a different county.

-- I caught a cold in Moscow and was very congested, which interfered with my sleep and Elavil did not work. I had to use Zyprexa. Zyprexa made me sleep even while congested.

-- As a result, I continuously used Zyprexa for many days and gained weight - you know how it happens.

-- Prozac works well as an AD but might be causing a little hand tremor. I would like to try Wellbutrin instead, because I have heard that it might help with the weight loss efforts. If it does not work, we will go back to Prozac.

-- I could not tolerate Topamax. I even reduced the dose to the bare minimum and still could not tolerate it. I actually did not have the most frequent side effects you warned me about. Instead, I had: dizziness, nausea, anorgasmia, and a general malaise. I hated it. Plus, while it did diminish the frequency of migraines, it actually provoked a few migraines because I was not drinking enough fluids due to nausea and was skipping meals, both migraine triggers for me. So please remove this prescription.

-- I did not take Geodon while I was taking Zyprexa, for obvious reasons. I was surprised to find out that my skin did not break out. I forgot to pack my Tazorac and normally skipping a single night of Tazorac would result in a break-out. Nope, I had absolutely clear skin. I figured that I had acne due to Geodon and not Lithium. Lithium is not to blame!

-- My latest neuropsych results show nothing on Axis I. This includes Schizoaffective. I thought back to the time when Risperdal was prescribed to me, to be replaced by Geodon later as I had Parkinson-like symptoms on Risperdal. My ex husband insisted that I had schizophrenia/thought disorder and he still thinks that. I believed him. I in turn insisted on an AP, and my then doctor was resistant, thinking that Lithium should be enough. She asked me what I hoped to obtain from an AP. I said "clearer thoughts". She reluctantly prescribed Risperdal. Later, doctors disagreed with the schizoaffective dx and thought that it was just bp, but the AP prescription traveled along with me from doctor to doctor. And I want to question it now - in my whole life I had 4 hallucinations total and nothing after 2011; I had hallucinations while being in episodes. Lithium prevents episodes. I want to try a good Lithium-AD combo without Geodon. Plus, as of this month I will no longer have free mental health care and Geodon costs hundreds of dollars while Lithium costs less than 10 dollars. I do know by now what mania is and I do have enough of Geodon at home to start taking it if Lithium turns out to be insufficient. Let us try it!

-- I want a one-time prescription of an emergency PRN sleep medicine, just in case I get a cold again and get congested to the point when Elavil stops working. What would you recommend - low dose Seroquel or Zyprexa again? I want less weight gain, obviously.

-- Thank you very much, I know it is a whole lot of things to handle during one appointment.