How do you know if you're on the meds that best suit you?

[salaatti]

How do you know that you're on the right combination of meds, the one that works best for you?

My diagnoses are depression and schizophreniform disorder NOS (I think. I haven't had anything official on paper for a year). I'm on 5 mg risperidone, 15 mg Abilify and 30 mg mirtazapine. My pdoc thinks this is the PERFECT combination for me right now, but I'm not so sure.

I was previously on risperidone and mirtazapine only, and adding Abilify has certainly been a step in the right direction. The change was made in late April, so I don't think I'll see any more improvement than I do now (I'm hoping to be wrong about this).

I do have good days, or at least, days when I can bother to care about things, which I can't when I'm depressed. I have a bit more energy than before Abilify, but I still get tired easily. I shower when I need to, get out of the house regularly, but those kinds of things were not much of a problem even when I was thinking about killing myself practically all day, every day.

I still have horrendously bad days, when I'm constantly thinking about killing myself and what a good thing it would be to not exist. I also have days when I'm certain that I'm being manipulated and everyone I know is in on it. I have nights when I'm sure that "they" (the ones behind the manipulation) want me to kill myself. During those times, I do realize that there's a possibility (even though it seems remote) that I'm not thinking clearly. That's mostly what keeps me alive during the bad days and nights.

Lately I've been unable to ride the bus to town, if there's someone on the bus who looks a certain way. It's hard to put to words, I don't know these people at all, but there's just something about them that makes me feel like they're reading my mind and I have to get away from that. There are some other similar things that affect my life, but not overly much. I can always take the next bus or walk.

I'm just wondering, is this as good as it gets? Am I just going to have to accept that I have symptoms that won't go away even though I keep taking my meds? I haven't tried many others, I was previously on Seroquel, but that was deemed inadequate for my needs. For depression, I've tried some SSRIs, but those make me extremely restless and I tend to gain weight on them.

[CrazyCatLady]

I still have horrendously bad days, when I'm constantly thinking about killing myself and what a good thing it would be to not exist. I also have days when I'm certain that I'm being manipulated and everyone I know is in on it. I have nights when I'm sure that "they" (the ones behind the manipulation) want me to kill myself. During those times, I do realize that there's a possibility (even though it seems remote) that I'm not thinking clearly. That's mostly what keeps me alive during the bad days and nights.

Lately I've been unable to ride the bus to town, if there's someone on the bus who looks a certain way. It's hard to put to words, I don't know these people at all, but there's just something about them that makes me feel like they're reading my mind and I have to get away from that. There are some other similar things that affect my life, but not overly much. I can always take the next bus or walk.

I'm just wondering, is this as good as it gets? Am I just going to have to accept that I have symptoms that won't go away even though I keep taking my meds? I haven't tried many others, I was previously on Seroquel, but that was deemed inadequate for my needs. For depression, I've tried some SSRIs, but those make me extremely restless and I tend to gain weight on them.

Have you told this to your pdoc? I can't imagine him/her saying that your meds are working well if you've described all of this. It's good that you can realize that you're not thinking clearly, but you shouldn't be having thoughts of "them" wanting you to kill yourself and that people are reading your mind. I'd either talk to you your pdoc and increase/change your meds, or maybe find someone new. Sorry you're having a bit of a rough time, I hope you find something that works better for you.

[gizmo]

If you don't have 90% symptom relief, keep pushing for improvements. If you are having suicidal days, then you need to let the pdoc know.

Let's face it, we will never be symptom free. But almost symptom free should be a good goal.

[salaatti]

Thanks for the input. I see my pdoc tomorrow about the meds and am currently trying to make a list of arguments why I feel my current combination isn't perfection itself. The thing is, I'm not that good at defending my views, especially when talking to people who are more knowledgeable about things than I am. I just tend to smile and nod and keep quiet, but I hope the list will help me speak my mind.