Ketamine infusions #2 & #3

I underwent my second ketamine infusion on Monday and listened to 90s alt rock. That…was different. I have discovered that recreational drugs would not be a thing for me. Thank goodness this is all under a controlled environment and I’m being monitored by a nurse and a doctor.

On Tuesday, I ended up being grumpy and irritable again. I can’t say for certain whether I was irritable due to the treatment or my kids just being assholes. I suspect it was a combination of both. Regardless, I felt okay on Wednesday.

I underwent my third infusion Wednesday afternoon and I feel okay still. It’s Wednesday evening and my brain is firing on all cylinders, I’m not sleepy, but I am very “out of it.” I don’t feel “all here.” I know sleep will help rectify it but it will be interesting to discover whether I am irritable again tomorrow (a snowstorm that will keep my kid home is likely to do it) or if my mood is somewhat better. My mood rating according to my rating scale is a 7. My guess is that my doctor would like me to shoot for a 9 by my last infusion (happy) but I’m content to just be “okay.” I’m always “here.” I’m never doing great or feeling fantastic unless I’m manic. Is it possible to get the euphoria of mania without the downside of the crash? It would be nice to know. Although I do have more energy and motivation for things than I did before the infusions.

Most importantly, my baseline is whether I’m dealing with suicidal thoughts. I did suffer from a little depression 2 days after my first infusion but since then, I’ve been okay. Before my first infusion, I took the PHQ-9, and I scored a 17. Today, before my third infusion, I scored a 6. I’m not sure what the hell happened but I’ll take it.

I think my pain points will be trouble falling asleep and staying asleep and overeating. I’ve been having difficulty concentrating lately so that might also be a factor that may keep my PHQ-9 from dropping much more. And I’m also super restless. Like I have too much energy that I need to burn off. I’ll use my son’s words: “fizzy feet.”

Ketamine infusion #1

I’m undergoing a series of ketamine infusions for treatment-resistant depression. It’s a series of 6 sessions over the course of several weeks. 1-2 sessions per week.

I had my first infusion on Wednesday for an hour and it was certainly trippy. I listened to soft rock in a completely new way.

I was kind of hoping that effects would begin to take place soon after the infusion. Relief can start to take place within an hour of the first treatment. While I was not depressed or suicidal, I was not happy. In fact, I was irritable. Angry. My doctor and I are on guard to ensure that the ketamine doesn’t trigger mania since I actually have bipolar disorder and not unipolar depression. At this point, I feel like mania would be an improvement.

I’m already pessimistic about the treatment even though my doctor says it can take 3-5 infusions for relief to kick in. My next infusion is Monday. Well, there’s one thing: If I ever wondered whether I’d like doing drugs recreationally, I’ve gotten my answer by getting it legally. (That’d be a no.)

According to a survey published by the Commonwealth Fund and Social Science Research Solutions, a third of Americans reported feelings of stress, anxiety, and sadness that difficult to manage on their own. Researchers posit that the lack of universal health care coverage, financial problems, and the government’s pandemic response has impacted the mental health of Americans in a negative manner.

The FDA has approved a nasal spray called Spravato to treat suicidal patients. The drug was approved for those with treatment-resistant depression last year, but has also shown promise to reduce symptoms in suicidal patients in conjunction with therapy and other antidepressants. The drug, while FDA approved, is only administered by a health care provider and is not approved for home use.

Loose Screws Mental Health News

Ebselen, an experimental bipolar disorder drug, has been found by British researchers to work like lithium but without lithium’s side effects. In mice. In testing, mice that were somehow made manic with “small doses of amphetamine” were placated with ebselen. Researchers are now moving on to testing on healthy human volunteers before studying those suffering with bipolar disorder.

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A study, published in JAMA Neurology, discovered that retired NFL players were more likely to suffer from depression and brain impairment. The study comes on the heels of the suicides of Dave Duerson, Ray Easterling, and Junior Seau. Researchers suspect a link between “hard hits to the head and depression.” These problems have also been noted in NHL players and combat soldiers who have suffered a brain injury. Many of the retired NFL players developed a type of brain damage called chronic traumatic encephalopathy (CTE). Duerson and Easterling were found to have CTE during autopsy. In related sports news, the UK’s Telegraph reports that depression is a problem for soccer players in England and Scotland.

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According to Time magazine, ketamine—a drug that induces hallucinations and other trippy effects—may hold potential as an antidepressant.

And now scientists report on two formulations of drugs with ketamine’s benefits, but without its consciousness-altering risks, that could advance the drug even further toward a possible treatment for depression.

Ketamine is seen as a fast-acting antidepressant for those at high risk for suicide. GLYX-13, mentioned here previously, is a ketamine-like antidepressant currently in clinical trials. AstraZeneca has AZD6765, a “ketamine mimic” that does not appear to be as effective as actual ketamine.

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New research has discovered that people with mental illness are more likely to be victims of domestic violence. Even though the study evaluated men and women, the results for women were overwhelmingly striking.

It finds that women with symptoms of depression were 2.5 times more likely to have experienced domestic violence over their lifetimes than those in the general population, while those with anxiety disorders were more than 3.5 times more likely to have suffered domestic abuse. The extra risk grew to seven times more likely among those with post-traumatic stress disorder.

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An analysis of more than 1 million Scandinavian women has shown that taking SSRIs during pregnancy may not increase the risk of stillbirth. This study could help revolutionize treating depression in pregnant women.

“From our study, we don’t find any reason to stop taking your medication, because untreated depression may be harmful for the pregnancy and the baby,” [Dr. Olof Stephansson, the lead author of the new report] told Reuters Health.

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Finally, “gender identity disorder” has been removed from the DSM-V and has been replaced by “gender dysphoria,” a condition in which people are concerned about their gender identity. “Gender identity disorder” seemed to stigmatize gays, lesbians, and transgender individuals. The continuing inclusion of “gender dysphoria,” however, ensures that people suffering with gender identity disorder still have access to health care treatment. (In my opinion, the renaming of “gender identity disorder” to “gender dysphoria” is really a politically correct change. Homosexuality was removed from the DSM back in 1973.)

It’s Official: I’m on Abilify and Prozac

A cursory search on Google for Abilify + Prozac didn’t yield too many helpful results. I suppose it’s not a common drug combination. So far, I haven’t had any real side effects. I take Prozac in the morning and Abilify at night. I’ve also started taking my vitamins again after shirking them for quite a while: Fish Oil with Omega-3s, Iron (for slight anemia), Vitamin B-Complex with Vitamin C, and a women’s multivitamin.

I am a little nervous about taking an SSRI again because the last SSRI I was on (Effexor/venlafaxine) produced some nasty side effects (mania, night sweats, vivid dreams, brain shivers) along with the one I liked (significant weight loss). When I last blogged about Prozac, my only side effect was somnolence—a side effect I don’t appear to be experiencing this time around.

Are you on a drug combination? If so, what and is it working for you? If you used to be on a drug combination, what was it and did it help?

Lamictal & Abilify: Wacky Side Effects

Images from rxlist.com & drugs.com

Here’s a list of the side effects I’ve experienced recently taking Lamictal and Abilify (I can’t attribute any side effect to a specific drug since I am taking both):

1. Somnolence (I am sleepy within minutes after taking the drugs.)

2. Dizziness/vertigo

3. Tremors (At night, I think I’m having convulsions but my husband says I don’t move.)

4. Delusions (I think I’m dying before I go to sleep.)

5. Disciplined sleep regimen (I wake up for the day when my alarm goes off. That’s consistently been 5:20 in the morning.)

6. Poor balance (This may be related to the dizziness and vertigo.)

 

I’ll add more to this list as I experience any additional side effects.

Lamictal and Abilify: Back on Medication

Images from rxlist.com & drugs.com

After 2 years of not being on medication, I am back to a daily regimen of lamotrigine (Lamictal) and aripiprazole (Abilify) with lorazepam (Ativan) as needed.

Many of you may know, or may not know, what I decided to taper off of medication so that I could get pregnant. Well, that hasn’t happened. And my thoughts got to a point where it became life and death again. I didn’t want to go back to the psych hospital so I asked my psychiatrist for help.

My psychiatrist (God bless him) is a very conservative psychiatrist. He was the one who helped me off of medication 2 years ago, and he’s the one titrating my dosages up now. Lamotrigine is for long-term maintenance of the bipolar disorder, aripiprazole is for short-term maintenance of bipolar disorder and SAD (seasonal affective disorder), and lorazepam assists with severe anxiety as needed. I started taking the medication four weeks ago, and I’m only on 50 mg of lamotrigine and 5 mg of Abilify. There will be no increase on Abilify and I titrate up on lamotrigine every 2 weeks. My next big jump is 100 mg.

My psychiatrist expects me to come off of aripiprazole within the next few months (hopefully by December). If not, I will have to get regular blood sugar and cholesterol tests performed. He will adjust all medications as necessary in the event that I am pregnant. He’s a great psychiatrist; he’s willing to work with me based on my situation rather than him throwing drugs at me. He allows me to have complete control over my treatment regimen, which is something I like and respect.

In the past, I may have come off as anti-medication, but really, I’m not. I advocate for use of medication in a necessary, responsible manner. In 2010, 253 million prescriptions were written for antidepressants.¹ (Keep in mind that the U.S. is estimated to have 307 million people in the country.² That’s about 82.4% of the population taking antidepressants.) This is not responsible; this is too much. In the comments, people have rightly corrected me in the assumption that 1 person can get multiple prescriptions in a year; I failed to remember that.

Let’s assume a person is on 1 antidepressant (the majority of people take 1). Beginning in January, that person gets 5 refills for 30 days. By May, the person will need another 5 refills. Then another prescription is dispensed in October. That’s 3 prescriptions per person. Of course, this can vary depending on how often the doctor will see a patient so let’s generalize and say 5 prescriptions per person per year. My calculations for prescriptions per American mean that nearly 20 percent (about 17%) of the population is on antidepressants. Sure, it’s not my original ridiculous number of 82.4%, but I still think this is pretty high. (By the way, feel free to correct my stats in the comments if necessary; I don’t claim to be a math wizard.)

While I am not on an antidepressant, I am one of the millions of Americans who is on medication for mental illness. For 2 years, honestly, I’d forgotten I had anything relating to mental illness. It was nice to wake up and be myself without thinking about me plus bipolar disorder. Every morning and every evening, it’s now me plus bipolar disorder plus SAD plus anxiety. These are all real symptoms that need to be managed. I don’t want to be dependent on this medication forever, but I may have to. If it helps me manage my suicidal thoughts and function with people in life, then it’s worth it.

Your turn: What do you think about taking psychotropic medication? Do the symptoms outweigh the risks for you? What’s been your experience in taking (or not taking) psych meds?

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Notes:

1. Shirley S. Wang, “Antidepressants Given More Widely,” The Wall Street Journal. Published on August 4, 2011. Available at: http://online.wsj.com/article/SB10001424053111903885604576486294087849246.html. Accessed October 20, 2011.
2. Google Public Data Explorer. Population in the U.S. Last updated: July 28, 2011. Available at: http://www.google.com/publicdata/explore?ds=kf7tgg1uo9ude_&met_y=population&tdim=true&dl=en&hl=en&q=us+population. Accessed October 20, 2011.

Lamictal-free and lovin’ it

I’ve been off of Lamictal for the past month and a half thanks to a wonderful supportive mental health community of bloggers. I’ve replaced my Lamictal dosage with 1000 mg of Omega-3s derived from fish oil capsules. So far, so good. I haven’t felt suicidal although I do admit I’ve caught myself wanting to feel suicidal. Believe me when I say it’s significant progress to go from feeling suicidal to wanting to feel that way. (By the grace of God.) Special thanks goes to Gianna at Beyond Meds and Stephany at soulful sepulcher.

I haven’t blogged on mental health lately because I haven’t had much to blog about. Any attempt at regular blogging now is mostly done at This Journey Is My Own, which is distinctively personal, reflective, and an unabashedly Christian blog. I guess it can be considered a scrapbook. Thoughts and rambles flowing freely through the blog. I don’t have the attention span, dedication, and motivation to do anything like I used to with depression introspection. I’m not averse to updating this blog every now and then but the months with 80-some odd posts are now gone. The Quotes of the Week should continue updating through early 2010. Enjoy.

Christopher Pittman seeks new trial

From Furious Seasons:

I simply don’t know what to make of the case of Christopher Pittman who was convicted of shooting his grandparents to death when he was 12-years-old–except that it argues for how risky it is to put young children on anti-depressants. Pittman, sentenced to 30 years in prison, is seeking a new trial and a hearing on that matter is underway in South Carolina.

You can read more about the Zoloft-rage/violence connection is relation to Pittman’s case.

Lamictal’s withdrawal effects at 12.5 mg

I’m at half the starting dose now. This means my body still has trace amounts of the drug but it’s so low that it’s not really effective. Here are the side effects I’ve been experiencing:

• Major brain fog
• Fatigue
• Dizzy spells
• Lethargy (ie, no energy)

I’m also having trouble losing weight but I can’t say for sure if that’s attributable to the medication. If you were on Lamictal or are on Lamictal, what side effects have you experienced?