I'm having a hell of a hard time and experiencing rather weird symptoms. Whether they've anything to do with Mirtazapine (Remeron) is something that I strongly feel but can't quite convince any doctor of. I was put on 15 mg of it in spring 2015 for depression and a severe insomnia - I hadn't slept an hour like since 25 nights back then! The benefits showed immediately within a day and surprised myself and my family. I would sleep well and be in a very happy and cheerful mood. Then however, from summer 2016 I developed some strange food intolerances; caffeine, sugar, fruits containing high amounts of fructose, yoghurt, butter and so on. Eating anything of that would cause me jitteriness and insomnia. I steered clear of those foods. From autumn last year though, a lot of those food intolerances have relented and it changed into intolerance towards medicines and supplements that I was on; the thyroid medicine for hypothyroidism, Vitamin D, Calcium, Vitamin E and could never again tolerate any new medicine or supplement. Symptoms resulting from these are, again, jitters, insomnia and a strange kind of feeling of being struck on the head, like I can't hear anything and the thinking becomes very unclear and blurred. Coupled with this is a weird sensation that if a medicine has any potential side-effect (even physical, such as urine retention), I get it at all costs. So I'm steering clear of the culprits here too. However, avoiding the culprits doesn't end my misery, it just helps in avoiding a whole new set of symptoms, because since autumn 2016 I'm under constant brainfog anyway, have heart palpitations immediately after every meal (but worst after breakfast), have concentration and focus issues, lead a life without any hobbies, wishes or desires. Nothing excites me, nothing interests me and nothing catches my attention. Leave tasks pending for months (the most unlike me habbit), have badly lost my sense of humour. My sense of humour was something that I literally used to pride on, and friends from around the world would call me to fresh up if they were having a dull day. My mind feels numb, although it isn´t as if it´s the sedating effect of the Mirtazapine because 90% percent of the nights I don´t sleep well, and on a lot of nights I feel as if I´m asleep with an awake mind! The GP who put me on it considered it to be just the effects of anxiety and depression and recommended the doubling of the dose to 30 mg. When I contested that, given that I´ve my doubts of a lot of these issues being brought upon by Mirtazapine itself, she referred me to a psychiatrist. He too strongly denies of Mirtazapine having any hand to play on it and instead thinks it´ll be best to combine it with another antidepressant for day-time. He put me on Paroxetine, boom, a flood of side-effects! Then changed to Fluoxetine (Prozac) - third day on it and having weird feelings. The heart poundings are one and is in fact making me very depressed and hopeless!
So, I'm bipolar, type 2. I tend to live in depression and only occasionally get the kind of manic you could replicate with a good caffeine high. I've been on Sertraline for over a year. I can't actually remember how long. I'm currently at 150 mg once daily, and I have been since October of last year. I also take Trileptal, recently reduced from 300 mg twice a day to 150 mg twice a day at my request. I requested the decrease in Trileptal because my pdoc said that it was the more likely cause of my persistent brain fog and exhaustion. I've been on that for a long time. 4 years? 5? Around there. The reduction in Trileptal doesn't seem to have made any difference.
I can't think straight anymore. I'm making mistakes at work, and my last mistake caused a minor injury. I'm tired from the moment I wake up until I finally pass out at the end of the day. But getting to sleep is difficult. No matter how tired I am, it takes forever to sleep. And then I tend to sleep lightly. I'm forgetting things. Important things. But not interpersonal things- just work things. I can remember the details about a coworker's date last week or what my boyfriend said about something two months ago, but conversations my boss has had with me about what she wants? Gone. Either I'm being gaslit (possible, she's known to think she had conversations with people that never happened, but this is happening more and more often) or I've got some big holes opening up in my head. And it's concerning.
One of my coworkers is also bipolar, and when we talked, she suggested that it's from having been on sertraline for as long as I have. Anyone had that happen? On sertraline or anything else?
I also take allegra for my allergies, vitamin b complex as well as a vitamin d supplement. Aside from a vitamin D deficiency, my bloodwork always comes back damn near perfect, though with COVID I haven't gotten it done this year. I tend to be very very sensitive to sedating medications- klonopin and benadryl both leave me groggy for at least a day afterwards and when I was on venlafaxine I couldn't stay awake. Wellbutrin xl gave me massive stomach cramps, and I got the lamotrigine rash.
So, I was extremely depressed in January after tapering off all my meds on my own (stupid). My doctor put me back on Wellbutrin, and we decided to try Prozac as an SSRI. The Prozac wasn't kicking in and I learned about the GeneSight genetic test for antidepressants. I asked for and had the task done. They never sent me a copy of the results.
After a month on the Prozac and no help, I also asked to go up from 300mg Wellbutrin XL to 450mg, and that seemed to help. I had an appointment mid-April and was mostly feeling better. He decided to keep me where I was at. I forgot to ask about the GeneSight results.
I generally feel good during the week but am miserable on the weekends. I generally lay in bed all day feeling depressed, binge eat, try and sleep as much as possible. I don't know if this is something that can be fixed with medication or if it is purely behavioral. My therapist suggests making plans for the weekend ahead of time and trying to make my weekends structured.
I finally got around to sending the doc a message on the patient portal asking about the GeneSight results. He responded that the report showed all my meds were good for me except Prozac. The test recommends Lexapro or Zoloft instead. He did not say anything about changing the Prozac.
For three days I have been trying to make an appointment to see the doctor. If I call I'm on hold for 10 minutes before leaving a message. I've also tried requesting an appointment with the patient portal. Nothing. So, I'm thinking about just messaging the doc (since I know he responds) and mention the problems I'm having on the weekends as well as concerns I have about staying on Prozac. I want to know if I should switch, or if I should just stay where I'm at since I'm basically doing good except no motivation and very depressed on the weekends.
What do you all think I should do? Ask the doctor online about switching, keep trying to make an appointment, or just try and add structure to the weekends and see if I can get by without a med change?
Current meds (all generic):
Wellburtrin XL: 450mg
hydroxyzine: 25mg 3x daily P.R.N.
Both are second-generation SSRIs, both exhibit minimal drug interactions via Cytochrome P450, both are the most prescribed SSRIs and are considered first line antidepressants. Who's been taking both and what were your experiences? (How did they compare to each other?). I am looking forward to read your experiences...
Which one did you like more?