purpose: normalize meds + show the impossibly long, trial-and-error process to finding some that work for you
I have been on my fair share of psychiatric medications for three years now. So, what’s worked and what hasn’t? Spoiler alert: It’s been a long and painful journey, and I don’t think it’s over yet.
In fall 2016 when I was a first semester freshman in college, I was having a harder-than-normal time with anxiety and mood. My PA (physician’s assistant – in the real of family medicine/normal doctor rather than psychiatry) prescribed me a low, low dose of escitalopram (Lexapro). Our goal was to “take the edge” and just make things a little easier. This was the first time that I took a psychiatric medication.
If you didn’t know, psychiatry is truly an art, not a science. It’s mostly just guessing and hoping something works. Sure, a doctor can glean some insight from a medicated relative or from a DNA test of sorts but ultimately every person is different. There is no “magic pill.” And it’s the frickin worst!
Honestly I do think Lexapro worked! That is, until it didn’t. Two years later I was taking over the highest dose of Lexapro, still without relief. It’s also important to note that I was still only conversing about my mental health with my PA, and a therapist in the summers, not a psychiatrist (mind doctor).
You may ask, why didn’t you see a psychiatrist when things were not progressing positively? Here’s how it goes: if people in your family don’t have mental illness or mental illness “bad enough,” you probably don’t know what to do. No one’s done it, no one will talk about it in society, and because mental illness is stigmatized.
When the high, high dose of Lexapro didn’t cut it, we added buspirone (Buspar) in conjunction. It made things probably five times worse. In fact, I used to keep just a sticky note of episodes, but fall 2018 was the time I started an entire pocketbook calendar there were so many. (This is why it’s essential to track psychiatric-anything.) Needless to say, I said bye to the buspar! (Just wait… this isn’t even the worst one.)
No doubt in the beginning of 2019 and the entire spring semester was the worst things have been for me. I was trying everything for help and I finally got in to see a psychiatrist (which I later found out was actually a nurse practitioner, aka not a doctor, but she could still prescribe). I started a drug called guanfacine which was explained to me as a drug used for aggression, specifically aggression in autism. Guanfacine is also used as a drug for high blood pressure and the idea was that it would slow me down or slow my impulses (which are so fast btw, it’s incredible!). It’s also apparently used for ADHD. (I will say – guanfacine is a really obscure drug to be treating someone with without trying any other SSRI, anxiolytic, etc. but I digress.)
So many meds!
|Medication||Class of drug + purpose|
|escitalopram (Lexapro)||SSRI, antidepressant|
|buspirone (Buspar)||anxiolytic (anti-anxiety)|
|guanfacine (Intuniv)||adrenergic receptor agonists (high blood pressure + ADHD)|
|sertraline (Zoloft)||SSRI, antidepressant|
|lamotrigine (Lamictal)||mood stabilizer, anticonvulsant|
|fluoxetine (Prozac)||SSRI, antidepressant|
|propranolol (Inderal)||beta blocker, high blood pressure|
While on this drug, guanfacine, for only a few months (this is NOT an SSRI drug which commonly take six weeks to reach full effect), I reached the lowest point in my life and in my journey.
Because that was not going to be the drug for me, I switched again. This time it was by a psychiatrist who “treated the symptoms” – as opposed to treating a diagnosis. This is pretty common, as shown in the guanfacine example. I was prescribed sertraline or Zoloft, a very common antidepressant, and lamotrigine (Lamictal), a mood stabilizer used for seizures and bipolar disorder (again, neither of which I have).
Either both or one of these meds essentially made me feel nothing, which, having been up and down and mad and sad and happy and excited usually within the same hour, felt great! I truly felt “blah” or “nothing” literally “no emotion” and I was loving it. Things were going really well. I had even started my new internship at home, and that was going well too!
Then it happened:
When you are prescribed any medication, doctors will rattle off the side effects with careful focus on the dangerous ones or most common ones or etc. With Lamictal that was, of course, “the (infamous in the mental health community) lamictal rash.” Where would I get the rash? I asked the doctor. It could be anywhere, said the doctor. And so, I would search every inch of my body the first couple of days after starting the med. So cute, I was. Thinking the rash would be on a small area of my body!
Guys, I’ll write an entire post about the Lamictal rash because it was that bad. It was literally that bad. Wanna see it? Google it. The. Lamictal. Rash. Fortunately, though, and this is fortunate – I did NOT have Stevens Johnson syndrome (Google that too!) which is where you probably die. I had the one that about 5% of people get but not the one that 2% of people get. Phew, am I right!
Literally the worst ten days in all of my life!
Anyway it’s safe to say that I did not take Zoloft nor Lamictal ever again and now I am on ANOTHER set of meds with ANOTHER doctor. I don’t think I have these meds set yet, but I will share anyway: I am taking propranolol (another med for high blood pressure and to slow heart rate, a beta blocker) 4x per day and the lowest dose of Prozac.
I can try to continue my meds journey/story on here. In the meantime, here’s my conclusion:
- If you haven’t tried any psychiatric meds and you have mental health issues that aren’t allowing you to be “you,” please try something. It’s not going to hurt you. Try the very lowest dose and it could make a WORLD of difference.
- You might get your meds on the first try or you might quite literally never get it perfect… that’s why you need therapy in combination with meds.
- Plan on the process being incredibly slow, especially if taking antidepressants. These drugs can take six weeks to take full effect. Does that seem like a long time? IT IS. Does that not seem like a long time? IT IS IF YOU’RE DEPRESSED WHERE EVERY HOUR FEELS LIKE A LIFETIME!
- It is also important to mood track BEFORE starting a new medication so you know if anything has changed. MAKE SURE to continue tracking your mood with a notebook or calendar or piece of paper so you actually know how you’re feeling while on the medication.
- Psychiatry should be a collaboration and a process between the doctor and patient. If you’ve read stuff about meds or diagnoses that you think would apply to you, bring them in. Ask questions. This is your treatment, not your doctor’s.
- Become good friends with your psychiatrist’s nurse. Mine has helped me so much over the phone! Honestly, sometimes I think nurses care about your well-being more than the doctors…
If you are reading this and you feel like you don’t want to be here anymore or you are considering taking your own life, please call the National Suicide Prevention Hotline: 1-800-273-8255. I want you here.
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