Hi AdamAnt
Within the past month, I saw my psychiatrist for the first time in 2 years (oops). He lives in Vancouver, I live on the island. During the winter months, I really struggle with a much more depressed mood and lower energy, which for someone who has those two symptoms for most of the year anyways, means it is very debilitating.
He wanted me to increase the Wellbutrin to the max dose (450mg) but I had a pretty strong reaction to that, so I stopped it after a few days. I am struggling with a new diagnosis of diabetes with elevated liver enzymes and triglycerides, so I kind of flipped out and sent him a panicked email saying I want off all the meds.
None of my doctors have ever done any kind of monitoring via blood work, despite me being on these meds for a little over 5 years, with the exception of the Wellbutrin, which was added 2 years ago. I have felt for some time that things are not quite right, and so went in to see my GP and told him I wanted a blood panel done. I had Seroquel as a PRN for years, and relied on it for the panic and anxiety and self injury. My psychiatrist just said in a reply email that yes, seroquel can cause diabetes but he wants me to stay on it because it is effective at lessening the anxiety. He has it prescribed now as 1/4 of a 25mg tablet every day. What he said to do with it is to stockpile that dose until I need it, and if I need it, then I will have what I need to get through that day. My gp over the past year and a half told me to stop the trazadone because he thought I was on too many meds, and to use the seroquel to sleep.
The Seroquel and the trazadone has been prescribed at a higher than needed dose, which allowed me to gauge how much I needed.
The psychiatrist suggested on the last visit that we try a low dose of Cytomel in the event the Wellbutrin didn't work. Cytomel is a thyroid medication that is the thryoid hormone T3. The human body produces T4 and then converts that into T3, but in more and more people, that ability to convert is retarded for whatever reason. From the reading I have been doing, low dose Cytomel has been used for some time now in treatment resistant depression. Many people who have low thyroid function and are prescribed only T4 end up with worse depression and low energy, so more and more doctors are adding Cytomel, and finding that the depression and energy improve drastically.
I think the one thing I would really strongly suggest to everyone is to read read read read. Educate yourselves as much as you can about treatment options, and medications. Some of the language can be a little daunting, but that does not mean it is entirely inaccessible. I had to learn to be my own advocate, because no one else was going to do it for me.