Thursday, May 1, 2008

Paxil, My Old Friend, Here We Go Again

Back in 2004, when I had Nervous Breakdown version 1.0, I was put on Paxil CR after a brief trial on Lexapro that resulted in a rather alarming instance of "Uh-oh! She's walking around in circles!" My relationship with Paxil CR lasted for a couple years with the help of a fat, funny little mustached side kick called Risperdal. Oddly enough, I also became a fat, funny little mustached side kick while taking this combination. I begged my state mental health professional to pay attention to the fact that I was gaining approximately 20 pounds per week, was sprouting hair in not-fun places and had stopped having my period.

She actually asked me, "Do you really need to have a period?"

So, as soon as I became employed and achieved health care insurance, I acquired a private psychiatrist whom I payed a rather large fee for each visit with the help of said health care insurance. Actually, like most of my previous and current health care providers, I still owe him some money.

The new psychiatrist said that I was on an excessively high does of Paxil CR, but first he wanted to take care of the Risperdal. He switched me to Seroquel. Seroquel and I got along very happily together, even after I weened myself from the Paxil CR and never did find another anti-depressant to suit.

My relationship with Seroquel lasted up until I had a lapse in health insurance. By the time my health insurance was reinstated, I found out that over-the-counter sleep aids with pain reliever could put me to sleep, so had started to use those instead.

I figured I could go off the Seroquel for good...

Introducing Nervous Breakdown version 2.0, wherein I have suffered severe anxiety, which has caused a host of physical problems, and which I have tried to treat with, first, Cymbalta (horrible - see misery diary post "Cymbalta: Satan's Candy") and now, back to Paxil CR, again. My new general practitioner - I no longer have a psychiatrist, at least not until May 13th when I go to see a new one - selected it from a list of anti-depressants I had tried in the past, deciding to re-try it because it only caused weight gain (at that point, sitting in her office, I didn't care about weight gain either, and still don't, as long as it doesn't get too bad, and so long as the Horrible Anxiety goes away).

This second time around, as I have researched and confirmed with Google is quite often the case, I am having more severe side effects with the Paxil CR. These include nausea, loss-of-appetite, tiredness, weakness, weird dreams, restless legs and walking-in-circles anxiety.

In any case, right now I'm hoping to return to Seroquel, and maybe even reduce the Paxil CR again until I am using Seroquel as my primary care mental illness pill. It has become abundantly clear to me that taking an SSRI alone causes severe agitation for me, and that it must be supplemented. Unfortunately, my general practitioner doesn't feel comfortable prescribing Seroquel; because it is an anti-psychotic, she wants me to discuss it with a psychiatrist.

I'm still taking the Ativan, but am not entirely enamoured with it because the sedating effects do not last very long and because I know it is addictive.

I just want to have some energy without anxiety.

I just hope everything works out. Not just my meds, but my life, my sense of well-being.

I want to get a job so that I have one less thing (money) to worry about.

My general practitioner said that, with all the stress, my brain has probably been completely drained of serotonin.


I'm waiting for the return of the best parts of me, of clarity, of moments of peace and happiness, but also anticipating the sloughing off of old patterns of bad behavior. I know that this is part of the continuing problem, that this is why the problem continues, why it seems to go away but then come back.

I'm still learning how to take care of myself, first learning the lesson of just how important taking care of myself is.

Unfortunately, I am apparently very hard-headed and must be beat about quite a bit by the Universe before I finally get it.

Maybe I'll never truly get it, maybe I'll keep making mistakes, but I hope I start to make less; I hope that I learn, that I grow. I would say change, but I don't want to change so much as grow. I think grow is better. Change indicates that I am unhappy with who I am, which I'm not, but I do want to become more of my best parts, and learn to manage my least-best parts.


James said...

According to Helen Fisher, there are three brain systems that have evolved regarding mating and reproduction:
1) lust: allows us to go looking for a range of partners (sex drive)
2) romantic love: allows us to focus on and attempt to win a preferred mate
3) attachment: allows mammals to stay together, hopefully long enough fulfil species-specific parental duties

Each of these systems has a different chemistry:
1) sex drive - androgens, particularly testosterone (central for both men and women)
2) romantic love - high dopamine/low serotonin
3) attachment - oxytocin and vasopressin

The reason I open with all of that is to bring up a fear related to the pervasive long-term use of serotonin boosting antidepressants. Antidepressants account for huge revenues in the drug industry and they are being prescribed by lots of different types of medical practitioners to lots of different types of patients. I have no worries for the short term use of these drugs and am sure they can be quite helpful. Its the long-term, year-after-year use that is the cause of my fear.

Simply, these drugs boost serotonin, which surpresses the dopamine circuit. Dopamine IS romantic love. So these drugs (in addition to all the other side effects you allude to) kill the sex drive, the chemistry of orgasm, and the flood of drugs that occur with attachment. A world without love isn't ideal, and this medical trend seems to be creating just that.

*reposted with an edit to fix punctuation.

Amber said...

yeah. thanks. I need that kind of info. It's not like I'm not already stressed out about my brain enough, right?

Because I can't tolerate an imperfect blog, I deleted your first post where you apparently messed up your punctuation (according to your own note at the end), but in your second attempt you left out a word.

so there.

Seriously though, I'm glad I'm not a scientist because I would probably be even more anxious than I am already.

Fuzzy said...

I have been on many antidepressants the last few years with little or no improvement. Finally asked my doc for the original, Prozac, and lo and behold, it seems to help. Hey, if Tony Soprano takes it, how bad can it be??? Ever tried it?

Amber said...

Thanks for reading and responding, fuzzy. How did you find my blog? I'm trying to find ways to get more readers.

I haven't tried Prozac, although I've heard good things about it, aside from the weight gain.

Have you ever read Prozac Diary by Lauren Slater? It was one of the first books I read back when I was first dealing with the prospect of taking medication for depression.

I never watched an episode of The Sopranos, but Tony Soprano seems like a cool cat. I've heard about the actress who plays his therapist/psychiatrist having either depression or bipolar disorder.

Thanks again for reading!

Fuzzy said...

Amber, first off I found your blog by clicking on humor in my interests section of my profile. All bloggers with that keyword in their interests will show up. Also, any book or movie or music type can be done the same way. As far as getting readers, I'm stumped. Maybe you have to be in Blogs of Note before you start getting traffic. I posted a message on the share your blog section of Blog Groups, and still have no traffic. There are so many blogs here, I'm surprised anyone can gather an audience. Also, if you comment on another blog, maybe that person will visit.
As to your post, I have been on the Prozac for about 3-4 months and I am gaining weight. I also quit smoking, so that could contribute to that. I've never read any books on depression, nor have I ever been to a psychiatrist for it. I've fallen into the mindset of "give me a pill for all my problems". I'm about ready to rethink my position on this.
Anyway, sorry for being so long winded. Have a great evening.

Amanda said...

They put me on seroquil to try to curb a severe period of mania two years ago. Unfortunately, that mania was triggered by the fact that I was suddenly losing weight and had enough energy to exercise for the first time in years, and about three weeks after I started that, the mania set in. The seoquil made me feel terrible. It certainly cut off my mania, not to mention it sent me into depression, caused the weight gain to start again, and made me lose all energy. yeah.

Bebsion said...

As an effective medicine, paxil would surely provide you immense relief if you are in the grip of panic disorder, depression or generalized anxiety disorder but it is altogether true that the usage of Paxil occasionally facilitates certain side-effects such as headache, low blood pressure, irregular heartbeat et al. These side-effects can yield serious results if not treated immediately hence take this medicine only on proper prescription.