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?
Sertraline standalone makes many people somewhat apathetic, indifferent and unmotivated, and that's why doctor Gillman suggests augmenting it with Nortriptyline OR alternatively taking Clomipramine standalone for the full SNRI effect...
Did anyone here try both combos? I am getting back on antidepressants and not sure how to proceed... but if I had to choose, I would preferably go for one of the two possibilities.
Anyone find Zoloft more motivating than Effexor? Any weight gain? (it made me insomniac with psychosis 20 years ago). But meds often act differently over time. I've already done trials (some multiple times) of:
Prozac (lethargic), Celexa (fatigue/apathy), Lexapro (similar to prozac), Cymbalta (vigilance/restlessness legs, but dissociative mind/feeling), Wellbutrin (no effect), Trintillex (no effect), Remeron (sedating/+appetite), Notryptaline (don't recall), Abilify (++appetite, RLS), ..Doc won't RX MAOIs and says that TCAs typically more sedating effects.
Basically, I don't want to take more than 3 meds (keeping with Lamictal & Ritalin). I want to avoid A/Ps...I like the calming feeling of Prozac & Effexor, but it's as if I am in this fuzzy cloud and I can't move or do anything, comfortably numb. Totally apathetic, in addition to sexual dysfunction, maybe my dosage is wrong. I'm also considering Viibryd, but don't know if it works on Serotonin...?