Help! Why do I feel worse at night?

[doghappy]

I take a cocktail of meds:

Morning: Celexa, Cytomel, Geodon, Provigil, Adderall

Evening: Lithium, Seroquel, Topamax

I feel very stable first thing in the morning (though I have a hard time waking up. I also sleep very badly). By @2:00 p.m., the anxiety and depression start. It's mild until about 5:00 when it escalates. I often end up going to bed early to avoid it. I can take Seroquel prn during the day, which can help the anxiety but it makes me tired and afternoon fatigue is a problem.

Any thoughts? Should I be taking the meds at different times, splitting up doses? Thanks for any suggestions (I have already tried to get some answers from my pdoc to no avail).

- Kiki

[gizmo]

I'm not an expert on stimulants, but what's sticking out at me is that you're taking all of your stimulants in the morning, specifically, Adderall. Adderall could be the culprit since you're dipping midday. See what your doc thinks about dividing the dose throughout the day. It's worth a shot.

From what I know from caring for my ADD son (please don't flame me because I haven't taken it), Adderall has a 6-8 hour effective life span. There is an extended version for those who need longer coverage. Perhaps that might be an avenue you want to persue if the dose dividing susanb discussed doesn't work for you? But an XR might make your ability to sleep worse - bite the hand that feeds you, so to speak. My son takes concerta at 7 am and has a horrid time sleeping.

This may be super small as to not help you, but if you take more than 300 mg of lithium, you might try splitting to doses into morning/night to see if it helps. I know lots of people take all of their lith at once, but I split my dose into 600/600.

[sorrel]

Also, it may be totally non-med-related, since feeling worse toward the end of the day is a hallmark of "atypical depression." This type of depression is common in those with bipolar.