To Medicate or not to medicate...

Freddyt

MyPTSD Pro
So to start, I am on Cortisone Acetate, Flourocortisone, and Synthroid as maintenance meds for Addison's disease. All good and stable. The only med of those that has changed since I was diagnosed is Synthroid.
In between there and here there have been three addiction episodes with Codeine. The last one was scary.

Now I am being handed new med's all the time and I really don't trust the fact I have have been given them by 4 different doctors. So the list:

Lorazepam - From the dentist. Got a few tabs for before visits. I have no problem with this one.

Rexulti - got as far as "dangerous drops in blood pressure" before that was a solid no. I know what happens when my blood pressure drops seriously and one of the worst parts is general confusion - like worse than brain fog and that means I may not reach out for help.

Vyvanse 10 mg - Hated this stuff. Felt like I do when over-medicated from my maintenance meds and blood pressure was up. Dangerous for me because a drop in blood pressure is the first sign something is wrong like I have a flu or cold or an infection that could kill me. Took it for a week and quit. One thing it did do was change my bedtime. If things are right I can get to sleep before 2 AM (Yeah...)

Sertraline 50 mg - This one is addictive no? I want to stay away from addictive because of past problems. Basically getting it filled so I can get support money. The Psychiatrist said they want to see you medicated before they offer support so...

The reality of where I am is trauma has been found - twice. Really since December we haven't added more than a couple reprocessing tasks. Therapy has been more about dealing with executive function stuff that continues to be the biggest source of frustration / anxiety for me. I know I may have some mild depression but I think its more associated with having to put on the "disability" tag than anything else at this point. Unless there is something hiding in memory I think we have done therapy for trauma and I feel way better than I have since September. No big struggles right now just a bit of agoraphobia because I haven't been out and around people enough and a huge blind spot where my trigger spot is.
 

Survivor3

MyPTSD Pro
I've only had experience with sertraline, can't remember what dose. It made me feel better when I woke up but really edgy during the day which put me at risk of using alcohol to calm down. My personal experience was that it was similar in effect of using cocaine.
 

Sideways

Moderator
For me? Medication is a love/hate thing. I definitely function better with it than without it, but I'm very regularly complaining to my treatment team that I'd like to be on a lot less.

It's taken a conga line of trial and error to find stuff that helps. None of the SSRI's helped my depression, probably because it's in the context of cptsd, rather than straight mood disorder. Sertraline was one I tried, it's very popular for treating depression, but no joy for me.

I'm not surprised you wanted the vyvanse gone, even without factoring in addiction issues. I was on its best buddy, dexamphetamine, for quite a long time, and wooo! That bought its own entourage of issues to deal with.

I am slightly surprised you don't have an issue with the benzo? I was still using diazepam (much the same as lorazepam, but a longer half-life) as prn medication (take it when you need it, rather than a regular dose) once or twice a week for anxiety up till about 6 months ago. Micro-dose. So I was surprised, when I stopped taking it completely, that I not only suffered withdrawals, but that once those withdrawals passed, my anxiety improved! So, it had long outlived its initial helpfulness even though I was using next to nothing (Read: addiction, with zero effort on my part! Probably after a few weeks, there's dependency issues going on, as opposed to the few days you get with codeine, but benzos are right up there with opiates as far as addiction issues go).

I can definitely recommend paying for the genetic testing to rule out medications that you're going to have side effects to. That would have reduced the number of missteps I had to take substantially.

My 2 cents? There's a lot of different classes of psychotropic medications these days. And lots of off-label and atypical medications to add to that. Even when you've got a shopping list of medications you've tried, it may still be that you've only scratched the surface of the types of medications available.

If you have the stomach (and time, and finances) to keep trying? Or conversely, if you're reeeeeally unstable and talk-therapy just ain't cutting it? Medication for a lot of ptsd symptoms gives the kind of help that we often can't get any other way (usually because of our symptoms).

Once I found stuff that works (and my shopping list is more than 30 failed medication trials, with more untried possibilities still available), it changed the game completely. I am still experiencing a weird, daily "is it really possible to just feel okay like this!?!", and my medication plays a big part of that.

It helps to have a pdoc who is not only good with medication, but also good with trauma. I haven't found one yet - I've needed a team to get it right. But it can be done. Like all things reocvery-related, it's no cake walk.

But then, for me, staying as unwell as I was, wasn't an acceptable option either.
 
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Freddyt

MyPTSD Pro
I'm not surprised you wanted the vyvanse gone, even without factoring in addiction issues. I was on its best buddy, dexamphetamine, for quite a long time, and wooo! That bought its own entourage of issues to deal with.
It was more about that I feel changes in my Addison's. Stuff that interferes that could kill me a lot faster than any other problems I have.

Or conversely, if you're reeeeeally unstable and talk-therapy just ain't cutting it?
No. I haven't gotten to the place where I really unstable, or self harm, or have deep depression. I have probably been close to psychosis but that was a couple years ago before I started therapy or knew what was going on.

It helps to have a pdoc who is not only good with medication, but also good with trauma. I haven't found one yet - I've needed a team to get it right. But it can be done. Like all things reocvery-related, it's no cake walk.
That's the other point, The Rexulti and Vyvanse were from my GP and the sertraline from a Psychiatrist I met once (for an hour). My current level of distrust for the medical profession is not helping my level of trust in starting a course of new meds.
Sure wish my Uncle was still around. He was specialized in Emergency Medicine and was an excellent resource. (Maybe I need to check that out for Trauma too, he used to work at LA County Medical Centre in emerg. The first time I walked in I thought the floor was brown...it wasn't)
 

Freddyt

MyPTSD Pro
I guess what I will be doing is keeping up the sertraline script (to make whoever happy I'm on meds wwhile im applying for support) but not consuming.

I will ask my GP for about a dozen Lorazepam for stuff I know will be really stressful, like my grand nieces first birthday party next week.
 

reallydown

MyPTSD Pro
So to start, I am on Cortisone Acetate, Flourocortisone, and Synthroid as maintenance meds for Addison's disease. All good and stable. The only med of those that has changed since I was diagnosed is Synthroid.
In between there and here there have been three addiction episodes with Codeine. The last one was scary.

Now I am being handed new med's all the time and I really don't trust the fact I have have been given them by 4 different doctors. So the list:

Lorazepam - From the dentist. Got a few tabs for before visits. I have no problem with this one.

Rexulti - got as far as "dangerous drops in blood pressure" before that was a solid no. I know what happens when my blood pressure drops seriously and one of the worst parts is general confusion - like worse than brain fog and that means I may not reach out for help.

Vyvanse 10 mg - Hated this stuff. Felt like I do when over-medicated from my maintenance meds and blood pressure was up. Dangerous for me because a drop in blood pressure is the first sign something is wrong like I have a flu or cold or an infection that could kill me. Took it for a week and quit. One thing it did do was change my bedtime. If things are right I can get to sleep before 2 AM (Yeah...)

Sertraline 50 mg - This one is addictive no? I want to stay away from addictive because of past problems. Basically getting it filled so I can get support money. The Psychiatrist said they want to see you medicated before they offer support so...

The reality of where I am is trauma has been found - twice. Really since December we haven't added more than a couple reprocessing tasks. Therapy has been more about dealing with executive function stuff that continues to be the biggest source of frustration / anxiety for me. I know I may have some mild depression but I think its more associated with having to put on the "disability" tag than anything else at this point. Unless there is something hiding in memory I think we have done therapy for trauma and I feel way better than I have since September. No big struggles right now just a bit of agoraphobia because I haven't been out and around people enough and a huge blind spot where my trigger spot is.
I don't think sertraline is addictive. But not sure. I am still on it - 150mg. I think 50mg should be okay? But definitely check with your doctor. I tried Welbutrin and it was awful, as was Celexa. I don't really have experience with any other meds.
 

DharmaGirl

MyPTSD Pro
Sertraline is not addictive. You will withdraw from it if you stop, but you won't crave it and steal from family and friends to get it. I've been on it for about 20 years. It is the one drug that worked for me. I take that and Buspar for PTSD. I weaned myself off Klonopin last year and I will need to find a psychiatrist to get it again for prn.
 

pamcoco

Sponsor
I’m not a doctor by any means but do have some experience with some of the meds you list.

Sertraline is not addictive. It is however a drug that should not be stopped abruptly and takes a while to take full effect. 50mg is a very low dose and I would say less than therapeutic for most people. I think 100-200mg is the more usual dose.

I far prefer Escitalopram. Both these SSRI are used to treat depression, ptsd, OCD and anxiety. The anxiety effect is the slowest to hit and it isn’t uncommon to be prescribed a short acting anxiety medication for the first few months. Now these drugs can be extremely addictive, although Lorazepam is far less addictive than many of the other anxiety meds.

I firmly believe pharmacology is an art but in a financial pinch it doesn’t hurt to do research. I would prefer to not be on psychotropic medication but have thus far been unable to go off them. I am pretty sure that for me this is largely due to autoimmune disease and chronic Lyme/Bartonella Infections.

I wish you healing in whatever form it may come.
 
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