Posted by bleauberry on January 26, 2010, at 17:44:29
In reply to depression is getting worse, posted by nolegirl323 on January 26, 2010, at 0:24:08
This is such a sad story and I'm so sorry you are experiencing this. No one can offer the magic solution, but some ideas to consider...
Get another doctor ASAP. You don't have to do a direct switch, but a second opinion never hurts. When the drugs one office is giving you are failing you, it usually takes someone else's fresh look to change those drugs.
The diagnosis doesn't matter much. Trying various meds to see what helps is what matters. When doctors get too hung up on the diagnosis, they can accidentally rule out drugs that could have you feeling wonderful. A diagnosis is not fact. It is a subjective educated guess and will vary from doctor to doctor.
I suspect the very meds you are taking are making you worse. The most guilty is the 400mg of Lamictal. It is used in depression treatment, it is used in bipolar treatment, and it does work about as often as anything else. But...it is primarily for epilepsy and seizure control. Furthermore, a not uncommon side effect is worsened depression or causing depression. In clinical studies with the patients that it did work with, it didn't continue to work past 9 months. (speaking of depression, not epilepsy)
And on the topic of lamictal, it needs to be known that the noted difference between generic and brand is rather stunning. People right here who have tried both can attest to that. Someone doing well and stable on brand lamictal will often relapse when switched to brand, and higher doses of the generic do not help them. Generic fans of course will say they are the same active ingredient with no difference. Real-world users have quite different stories of what happened to them. Bioequivalence does not equal clinical equivalence. Unfortunately, generics are not tested for clinical equivalence. My doctor is big on the generic vs brand debate. Of the half dozen drugs where he sees a huge difference, lamictal is one of them.
Benzos of any kind can worsen depression. Xanax is the least likely, but at your doses I think pretty much anyone would feel depressed.
Pristiq seems like a reasonable choice, though I would much prefer a true SNRI approach (which Pristiq is not, though claimed to be) which would be a Zoloft+Nortriptyline combo.
A complicated situation is actually pretty clear when it is narrowed down to logic. That logic is...
You are getting worse on the meds you are on, which means either: 1)They are not working for your chemistry, 2)They are making you worse than you would be without them.Either way, it is clear...the meds have to be changed. If that requires a different doctor to get the job done, so be it.
Four years is a long time. Let someone else take the helm and see what they can do, because the ones in control right now don't seem to be doing a very good job at all. Disgusting job actually. If they won't switch your meds, get someone who will.
Sorry to be so blunt. I want to see you get well as fast as possible. I don't see that happening as long as your current meds are continued.
> I am currently diagnosed with bipolar disorder II, ( I say currently because I've previously been diagnosed with clinical depression before my Dr. changed my dx.)
> For four years, I've been in therapy, on meds, and have been hospitalized 3 times for psychiatric issues. None of this is working, I'm only getting worse. I'm 28, I live in beautiful SW Florida, 10 minutes from some of the most beautiful beaches in the nation, I have a great job (that I enjoy when my depression allows me to leave my bed), I have great friends, but none of it is enough, somedays, I just want to die. I can't leave my house unless i have to, and the other day, while grocery shopping, a panic attack caused me to leave my entire grocery cart, full of groceries, in the middle of the grocery store because I just HAD to get out of there - I was suffocating.
> I currently take 400 mgs of Lamictal
> 50 mgs of Pristiq
> 4 mgs of Xanax XR
> .5 mgs of xanax IR
>
> My current diagnoses are Bipolar II, G.A.D., builmia nervosa, ocd, & I'm a cutter ( I don't know what the diagnosis for that is..)
>
> Despite my compliance with my current medication regiment, my condition is getting worse, and I'm not sure what to do.
> Has this happened to any of you? IF so, what did you do? Did it help?
poster:bleauberry
thread:935006
URL: http://www.dr-bob.org/babble/20100122/msgs/935071.html