Three Years, Five Months After Diagnosis
"Doctor," I said to the doctor, "I'm having a mixed episode."
This installment of the story really begins four weeks ago. I'd heard about Lexapro - the "new version" of Celexa, which is created by splitting the Celexa molecule in half and discarding the side that wasn't acting as an antidepressant and was thought to be responsible for most of the side effects. So ... when I went to see my psychiatrist last month, I asked about switching from Celexa to Lexapro. He agreed. The only concern was that I had been stabilized on 30 mg of Celexa with 300 mg of Serzone, and the smallest dose of Lexapro, 10 mg, is equal to 40 mg of Celexa. The doctor said I should cut Serzone down to 200 mg per day. He has been concerned about the potential liver damage as a side effect of Serzone, and even though my blood test for liver function came out just fine, he has wanted to wean me off Serzone anyway. This was to be the start.
A week later, my appetite died.
For the next two weeks, I had a lot of strange symptoms. It's very hard to tell what was caused by what medication. During this period I was trying out Claritin and Allegra for my unidentified allergies. I had some medical tests done and was stressed out waiting for the results (all FINE!). I went from feeling woozy and out of it, with horribly stiff neck and shoulders (fixed by chiropractor) to being queasy to having tight chest muscles to having wild dreams ...
Three weeks after switching to Lexapro I began to feel halfway manic. In spite of feeling very tired and aching all over, that Sunday I found myself potting up coleus cuttings while cooking chicken, making gravy AND baking banana bread from scratch - all at once. When I wasn't doing these things, I was spending money online and "attacking computer jobs like mad," according to my notes. I was hyper and uncomfortable. It was not a good kind of hypomania, the kind where you feel on top of the world, filled with confidence. It was more like being speeded up - driven. Fortunately, one of our volunteers, Erica, reminded me that I could take an anti-anxiety medication to help. I'd forgotten I had Ativan!
I called my psychiatrist the next day. He advised me to stop taking Serzone at once in an effort to decrease the likelihood that this was antidepressant-induced mania. So I stopped Serzone that day, cold, but it didn't really help. I'm still experiencing physical restlessness, mental agitation, irritability, wild dreams and light sleep. I'm also getting a lot more done than before. I am less depressed. I've lost weight, too, as my appetite is still smaller than it used to be. I feel ok when I wake up but by the end of each day I'm experiencing pretty bad muscle aches so I am taking Naproxen every night.
My mind goes and goes and goes.
Today - the day I am writing this - I met with my doctor and described my current symptoms to him. He said part of the agitation, which has gotten worse in the last ten days, could be from discontinuing Serzone. However, Serzone should be pretty much out of my system by now. His first suggestion was that I go back to Celexa, but I argued against this for two reasons. First - I am losing weight. That's extremely important to me. But also - I can see now, by comparison, that I was not doing as well as I thought, all the last many months on Celexa and Serzone. I was coasting at a level of depression just light enough that I could live with it. In spite of the fact that I am really uncomfortable now - it's better than depression!
We discussed the possibility of adding Buspar to my medication regime, but finally settled for something else. For the next week I am to cut the little Lexapro tablets in half and see how I do. I'm also to take two tablets of Ativan at bedtime to assist with sleep.
I hurt. I don't like standing still. I've adopted the "you can only buy on Tuesdays" method of self-discipline for curbing online spending. I'm grinding my teeth most of the time.
But I'm not depressed.
