Overmedicated

Whenever my pdoc gives me an increase in one of my medications, I'm good for a few days and/or a week or two...then I come right back down to a moderate depressive state. I was doing awesome this past week! I showered and left my house! I cooked! I felt like, finally I'm back to normal. But as the story goes, I came back down. I knew I was going to stay like this because I didn't even want to cook what I had planned to last night, and laid on the couch instead. I'm tired of this up and down pattern every two weeks or so. I checked the schedule and happened to see she had an appointment available in about 40 minutes, so I drove up there. She decided to try and increase the Lamictal again. From 200 to 250 then up to 300. One reason is because I'm afraid of an increase in Effexor (because I ended up hypo last summer) and Wellbutrin (because I felt like a zombie at 400). We'll give that some time and see how that works.
Then I started thinking, what do you all have to deal with? Do your pdocs just keep increasing or switch your meds for a new one? Does it make a difference? I know none of us are doctors, just interested in personal experiences. I'm in a whole new world here. Longest instability I've had...

I would reduce the number of meds as much as possible. Ideally, two that counterbalance each other. Experimenting is a lot faster and probably more effective.

So maybe (just) an antipsychotic together with the lamotrigine or only an antidepressant (I'd suggest just using an antipsychotic and the lamotrigine to do the antidepressive part).

Mine changes my meds quite a bit too. I sympathize with you...life is pretty hard when you are down on the couch. I really hate it when you start to feel good and get all excited and then, bam! you're down again.

My old pdoc used to just increase doses.

I was on a lot of meds, weaned myself down to just lamictal and gabapentin (and propranolol, but that's just as needed and I rarely take it), and I feel MUCH better not being on all those meds!

I hope you feel better soon! Lots of hugs!

Thanks! In a perfect world, I think Trileptal and Wellbutrin are all I need because I've seen the best results in those two.

My pdoc is very methodical. He starts with increasing/decreasing dosages. If that doesn't help, then he adds/removes medication. I think that's how it should be!

I would dump any pdoc who kept adding/removing medication without trying to tweak dosages first. If you just add/remove medication and you only try 1 dose, you're going to run out of medications fast.

Right now I'm not on too many medications, but my pdoc seems to be the kind of pdoc who adds medications without removing them. I think in the future that may be a problem.

I wish I was on Wellbutrin instead of Lexapro. I have ADHD and I've heard that Wellbutrin helps with that. So, it'd be a win-win for me... helps with bipolar and ADHD. My pdoc doesn't help with my ADHD symptoms (won't give me stimulants, Wellbutrin, or anything). So, I'm disappointed with him from that point of view.

Lithium. Lithium and more Lithium. That's what makes the world of the crazies go 'round. KIDDING!!!. I know you're scared of it.
In a perfect world you wouldn't have to take any pharmaceutical drugs at all.
In this one, the least possible to obtain the desired effect.
What suggestion can I give you?. I'm at the end of the meds-for-the-crazy road.
Take the Lamo increase and see what happens. You're far way from the maximum.
And it has worked for you before. Hang in there. We still have many to roast.

I'm on 2 ad, an ap, and an MS. The AD's make me jittery and my MS gives me dry mouth. Last time I was ip one of the pdocs asked "what do you want me to do you're already heavily medicated"

Before my medical leave, I was unstable, and my pdoc increased and decrease and changed meds to try to give me some relief. But, my chaotic teaching job and my unwillingness to make any changes to my life were bigger contributing factors to my constant distress. For me, getting rid of the daily exposure to violence and chaos, has given the medicine I take a chance to get traction. I don't know about next month or next year, but I think I'll still be celebrating my escape from hell. I know you didn't ask, but, while you're figuring out your meds, is there some hellish element in your life right now that you can kick out?

Nothing I can think of. If there is, it's buried deep in there. I love my job, I have my own house and can afford to support myself, a good car, expecting another nephew in a few weeks that I'm excited about. I do go to therapy every other week as well. So there are no current issues, if anything is wrong, it's from years ago...past relationships.

You got me there!!

Good 1.

I take 70MG of Vyvanse, 45MG of Remeron, 600MG of Lamictal, 300MG of Clozapine, 10MG of Abilify, up to 7.5MG of Haldol (prn), and 1MG (or up to 2.5 prn) of Klonapin. I feel incredibly overmedicated. I can barely stay awake after taking it and I move like a zombie. It is very difficult to live and especially drive like this most days. I am SO eager for another opinion and to very likely decrease the meds.

I am getting to the point of being over medicated with these increases in lamictal. Before all the junk I was already on I felt fine. I just want my life back.

I have the same problem you have with the sort-of depressive state that keeps coming back. I've switched anti-depressants with some success, but I'm wondering if decreasing my mood stabilizer is an answer. Of course, doing that scares me because I don't want a mania.

Switching anti-depressant helped. Starting Geodon helped. Of course, if I had a regular schedule or didn't touch my computer before getting showered and dressed I might do more. Who knows?

gina - Do you think you'd feel better on just one mood stabilizer and one antidepressant?

Pdoc always think upping the dosage or adding another med is necessary but from my exerience getting off one or reducing one can have the same effect. Of course your doc would have to agree to it but just my experience.

I think the smallest effective doses is the way to go.
I was oversedated for several months and it just made things worse. I had side effects from AP dose being too high. I'm trying to accept I need meds while not thinking they are the catch all for health and wellness. You have to find a balance. If you are so sedated you can't do basic everyday things, talk to MD. There is a balance, and plenty of evidence that the smallest effective dose should be used to maximize functioning. I hope things get better for you.

I would. It was like that for a few years before I became so destructive last year from an increase in my AD that threw me into hypomania, which I didn't realize at the time. Then I crashed hard into a deep dark depression. I was in PHP for three weeks. I was fine for a few weeks which is why I was discharged, but I have been so up and down since. My concern is keeping up with work. I love my job and don't want to jeopardize it. It's hard to work some days and get little done, or take PTO just because I can't work. I keep in touch with my pdoc through email and she advises me to go up each time. I just want to be able to function and work effectively. I stay home every weekend in bed and go days without a shower (I work from home half of the week). I also see my T every other week. But it seems we're working on past relationships now because there is nothing currently in my life that is triggering me. I feel like I'm to the point of having enough meds and whatever is causing this is buried deep and repressed because I have no idea where this is coming from.
That was more than I intended to write...

Very true. I wonder if it could be the Lamictal that can be the cause in the first place and I don't even need it. It hasn't done anything for me anyway. Thanks for this! I'll bring it up with her.
My previous pdoc had the philosophy of least amount of meds with the best effect. But I left him since he said I should get a second opinion because he didn't how else he could help me. I was in PHP the next day.