Welcome to my medication history!
These records exemplify the often slow and frustrating process of finding the right combination of medications to treat each individual person's Bipolar Disorder. The latter portion also demonstrates the importance of being aware that life events and seasons can affect a person's need for changes in medication or dosages.
Not everyone goes through a long, involved process! But some of us have a hard time finding the best mix or have to change medications for other reasons.
The referenced articles are from my online journal, I'm Bipolar. Very briefly, before diagnosis I had a long history of depression and sleep disorder, with one possible major manic episode in 1981 and sprinkled probable hypomanic or mixed episodes.
1987-1992
Medication:
• Amitriptyline 5-75 mg
Comments and Complications: Amitriptyline (Elavil) was prescribed for fibromyalgia. The dosage was gradually increased as patient developed tolerance to the drug. I slept properly for the first time in at least 20 years! However, my appetite increased dramatically and weight increased from 132 to 162 pounds. In 1992, I voluntarily went off the medication due to the discomfort of increased weight and accompanying jump in cholesterol levels. In one year my weight decreased to 125 pounds and cholesterol levels became acceptable again. (There were additional life-event causes for weight loss.) Sleep problems returned.
1994-1996
Medication:
• Prozac 20 mg
Comments and Complications: I developed major depression and Prozac therapy was instituted. Prozac worked wonderfully at first - may have induced mild hypomania, but there were no risky symptoms. After one year, however, Prozac gradually grew less effective, and my weight increased from 125 to 145 (ideal weight is around 130-135).
1996-1997
Medications:
• Prozac 40 mg
• Trazodone 25-50mg
Comments and Complications: Trazodone added after increase to 40 mg Prozac was not effective enough to combat returning depression. I also took a partial medical leave from employment due to on-the-job stress. In March 1997, I left that job and became hypomanic for some time in response to very positive lifestyle changes.
1997-1999
Medications:
• Prozac 40 mg
• Trazodone 50 mg
Comments and Complications: Depression slowly returned, particularly bad during winters. My weight increased to 155 by mid-1998. I quit smoking in November 1998 and suffered serious depression through the winter months while weight continued to increase.
March 1999
Medications:
• Serzone 300 mg
• Trazodone 50 mg
Comments and Complications: At my request, family doctor allowed her to try Serzone instead of Prozac in hopes of losing weight. Serzone caused steady problems with diarrhea. (Patient later learned that one is supposed to start with a low dose of Serzone and slowly titrate up. The doctor obviously didn't know this, either. Patient dropped this doctor.)
April 1999
Medications:
• Celexa 20 mg
• Trazodone 50 mg
• Klonopin ? mg
Comments and Complications: I visited a psychiatrist who also specialized in sleep disorders. Celexa was prescribed because it was apparently weight neutral, and Klonopin to help tone down my unusually vivid dreams, while Trazodone was continued to treat the sleep disorder.
After about six weeks of this treatment, I was sleeping only about five hours a night and exhibited other symptoms of mania, including rapid, overexcited speech. The psychiatrist then diagnosed Bipolar Disorder.
Article: What? ME? I'm Bipolar?
Medications in Bipolar Disorder: Trial and Error
• Prior to Diagnosis
• First Year of Diagnosis - May to December, 1999
• Second Year of Diagnosis - 2000
• Third and Fourth Years of Diagnosis - 2001/2002
• Fifth Year of Diagnosis - 2003
