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My pdoc has requested a set of full labs to be done within a month. I've been a bad girl with drinking and had some ugly liver enzyme nubers last time. I have been working on my reducing my drinking and would like a good test to show that I deserve the ever-liver damaging Wellbutrin to be restored. It's the only anti depressant I respond to.

If I really cut out some booze (really big effort), bomb myself with vitamins and milk thistle, and eat well, is it at all possible to show a better number so I can get back on my good med and continue to work on the drinking reduction?

Please no scolding. I do that to myself already. I just want my medicine back, get a handle on the drinking, and feel better! I'm not yellow in color (jaundice that is) or have a swollen abdomen or anything, so I think that poor little liver is still doing it's job.

Thanks for advice if you've been there and are scared of labs!!


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Liver function tests aside, your other labs may tell on you. MCV (mean corpuscular volume - the size of your red blood cells) rises with chronic heavy alcohol use. It takes up to 3 months for MCV to come back down to normal. Alcohol-related anemia is fairly common, and, again, takes 3 months to clear up. GGT (another liver function test) takes 2-3 weeks to come back down to normal. Ditto CDT (carbohydrate deficient transferrin), which gives a fair reflection of alcohol consumption in the prior two weeks.

Not scolding here, but I suggest just spilling your guts to your psychiatrist, point out that you've cut back, and ask for your Wellbutrin to be restored (or figure out conditions under which it will be restored). Might even think about getting this first batch of labs as soon as possible, so that you can retest in two-three weeks (during which you don't drink, or you cut back, or whatever you guys agree on) and show him or her that you're committed to trying to make this work. Again, not scolding, but when you want to get better, and when you're worried about your health, your psychiatrist is one of the people you really need to be honest with.

Also, as far as testing ASAP... I think it's a valuable thing for you to know the effect that the booze is having on your body. You're clearly concerned about substance effects, you are trying to get better, and I'm just wondering if maybe it would be helpful to have some clear-cut, real, "holy crap, I did what?" type numbers for reference and that you can use to help yourself with motivation. I just say that because I know quite a few people who were rather horrified when they found out their MCV was changing because of their drinking. Liver function tests are important too, but creating malformed red blood cells - that seems to make it personal for some folks.

Just an opinion.

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Liver function tests are important too, but creating malformed red blood cells - that seems to make it personal for some folks.

Personally, if I found out I had malformed blood cells, I'd want pics so I could use them as a screensaver at work. Or better yet a screensaver slideshow.

Anyway, my actual thoughts: I've always found my level of drining to respond fairly directly to my mood; i.e., I'm manic I'm drunk. Period. Well, dunno, but I sure drin a LOT and actual level of inebriation can be hard to tell...

Stable, I drink, but don't look up a few hours later and say "what happened to the 12 pack???" No, it's a couple beers for the ol' CNS and I'm good.

So. Point being: do you think that, if your mood improves, you'll drink less? Which could well of course lead to a further imporved mood and even less drinking...

I mean shit, you deserve to have a med that you respond to restored, particularly if you don't respond to others. Me, I can't blame you for drinking in that situation! (I know, it's shitty, circular, diseased logic, but I've lived it plenty)

The whole point of getting better, mentally, is to get ON the right meds and OFF the booze, so I say present it to the doc thusly. Shit, say it like this "well feeling better will aid me to continue in reducing or quitting drinking, and if I don't you can always take me off the WB like (insert some bad joke about a crappy show that got pulled...or not)"

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I think I worded that wrong. My doc is not completetly evil...

His thought is that maybe we shouldn't damage my liver further by having me take a drug that is notorious for putting your liver through the wringer.

My depression is a milder case and maybe there wouldn't a med at all for a bit. I just would prefer to have it back. I know the liver can be pretty resiliant and I'm young and otherwise healthy, so why not make a girl a little happier?

I've only been off WB about 5 weeks, on a med vacation to see how I'd do. A couple weeks into it, I felt crappy again and drank more, so that logic is correct.

Then a crapful try of the "less damaging" (whatever) Lexapro, which I completely rejected-or ejected, haha.

All else was fine on my labs a few months ago, just those pesky liver enzymes were elevated....

I have a whole bottle of Wellbutrin, I should just go back on, work hard on the drinking and do my labs on my last possible day (June 9th) after a huge push with the booze reduction. Then go in an say I misunderstood, have been on for 3 weeks and am doing very well!

Harumph, I hate this whole drinking/depression go-round...

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If you think Wellbutrin is hard on your liver - which is pretty rare and is at the case report level in humans, but I haven't read all your past posts, so maybe you have a documented history of that - then restarting it before you get another set of LFTs done makes no sense at all. Just saying.

If you don't feel you can be honest with your psychiatrist, then something needs to change in the relationship. That's a giant waving satiny red flag. Deception is not the basis for a good provider-patient relationship. You wouldn't put up with it from him - you'd think it was inappropriate. Goes both ways. And, yeah, I guess that part there, that was respectful scolding.

I never said he was evil, by the way. That's a curious interpretation on your part.

I'll second what CNS said.

Good luck with this.

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I apologize, I meant evil in a joking way. And I'll accept your respectful scolding as you are correct about being honest with my doctor.

I guess I'm just becoming frustrated.

But I know I need to accept the consequences about what I have done to my own body through drinking and I will try my best to act with responsibility ;)

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