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What the eff is going on with my psychiatrists?

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Gipe

Over the past 18 months, my psychiatrists have put me on about six or seven different antidepressants. Prozac and Zoloft made me sleep all day. So did Lexapro and Effexor (nauseous too). I can't even remember the others. But I know the side effects (immediately falling asleep and two days of nausea) were too extreme to put up with for longer than a couple of days.

The antipsychotics we tried had similar effects, so I could not stay on them for longer than a couple of days, either.

You'd think that after all of these trials, they would have decided that antidepressants don't work for me. But oh no -- she put me on 150 mg of Wellbutrin XL, and it's not doing anything at all. Do I need to increase the dosage?

I don't know what to do. I really want to find a medication that works. My symptoms are depression, anxiety, hopelessness, intrusive thoughts and suicidal ideation.

I know that none of you are doctors, but does anyone have any suggestions? My psychiatrist seems clueless. Is there another class of drugs we should be looking at?
 
There are no medications that treat PTSD andif your symptoms stem from PTSD and not a chemical imbalance, then antidepressants may not help much. You may need to treat the symptoms via therapy and maybe a stand alone anxiety medication.
 
But oh no -- she put me on 150 mg of Wellbutrin XL, and it's not doing anything at all. Do I need to increase the dosage?
Actually, they should have tried Wellbutrin sooner. It's a completely different mechanism of action - so, there's no comparing it to any of the others you tried. Since you are not experiencing negative side effects, yes, you should speak with your doc about raising the dose. There's a chance it will help.

But I know the side effects (immediately falling asleep and two days of nausea) were too extreme to put up with for longer than a couple of days.
Honestly - if you didn't give it 7-10 days, you don't know if it would have worked or not. I wish psychs explained this better. The side effects can vary drug to drug, but it is quite normal to feel like shit for at least 5 days. You need to think of it like having a weird flu. If you notice some kind of improvement in your psych symptoms after 10-14 days, but the side effects are still bad, then there's a choice to be made about backing down on the dose but adding an adjunct to 'boost' the effect, or getting off of it and going to a med that has similar action (ie, 'SSRI', 'SNRI', 'mood stabilizer', etc.), but different side effect profiles.

And if you've gotten to 10-14 days with no change in psych symptoms and still experiencing unremitting and intolerable side effects - then, you can know with more certainty that drugs in that class will likely be ineffective.

Experiencing unremitting and intolerable side effects across all classes AND having zero change in psych symptoms is generally an indicator that the issues can be (and need to be) tackled with skills training and therapy.

Basically: people often give up much too early. Side effects should be profound and/or psychiatric in nature, in order to warrant an almost immediate (2-3 day) cessation.
 
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If you're reacting to antidepressants and antipsychotics in the same way, my guess is that you may have a sensitive system that needs to get over the hump of side effects. These classes of drugs act in very different ways. It may be a matter of pushing through?
 
Side-effects - bleh! I've tried a whole heap of different options (was hospitalised for a few years, which made that possible) and mostly the side-effects were always at the worst over the first 5-7 days.

My sister, who's also spent years in the psych-sphere, is particularly vulnerable to side effects. She gets em all.

For both of us, I can confidently say that what we were able to put up with was directly linked to the seriousness of our respective conditions. And for both of us, medications have only ever been a supplement to therapy.
 
And if you've gotten to 10-14 days with no change in psych symptoms and still experiencing unremitting and intolerable side effects - then, you can know with more certainty that drugs in that class will likely be ineffective.
What do I tell my boss? There is a reason I had to quit after two days: I can afford to be knocked out/nauseous, etc. on the weekend. Monday, it's back to work. Taking two weeks off to get through hellish side effects of a medication that might work is out of the question.

Should I cut the dose of these meds way, way down and try again?

Experiencing unremitting and intolerable side effects across all classes AND having zero change in psych symptoms is generally an indicator that the issues can be (and need to be) tackled with skills training and therapy.
I am in therapy. Unfortunately, it is not helping with the day-to-day emotional pain a great deal. I guess because it is not just PTSD I'm dealing with, but chronic, concrete stress factors.

Since neither Prozac nor Zoloft (even after several weeks/months) did much except cause me to sleep 18 hours a day, I'm reluctant to try any more SSRIs. Does anyone know how antipsychotics differ from SSRIs? Would they help more with intrusive thoughts?
 
Should I cut the dose of these meds way, way down and try again
You should speak to your prescribing doctor, before stopping or starting medication, or changing dose.

These medications really aren't something you should be fiddling with on your own. There is no amount of online info or advice that will be an adequate alternative to advice from your doctor.
 
What do I tell my boss? There is a reason I had to quit after two days: I can afford to be knocked out/nauseous, etc. on...

Yes.

Antidepressants don't do shit IMHO for intrusive thoughts. Antipsychotics can work WONDERS on them.
 
As others have said there is no drug to treat PTSD, but some may help the symptoms. There is genetic testing that can help a psychiatrist identify a drug that you will have bad reaction to or your bdy does not absorb...helping them narrow down which otherwise seems like a crap shoot.
 
There is genetic testing that can help a psychiatrist identify a drug that you will have bad reaction to or your bdy does not absorb...
Wow, I never heard of this. Is it difficult to access?
 
I think it is becoming more available. I first had it done when it was in the opening stages. I got the impression from my new Dr. that it is becoming more available. Maybe ask your dr or insurance company?
 
For the genetic testing. You can go to any site like ancestry.com to have you DNA tested. With your results, they will give you a file with the raw data. You can upload the raw data into a site called promethease. It can the raw data to tell you everything you want to know, and don't want to know about your genetic health.Sites like ancestry only give you minuscule amounts of information but this site will tell you EVERYTHING.
 
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