Between my trip, illness and injury, it wasn't until May 23rd that I finally decided to try the appetite suppressant Ionamin. By that time I was back to exercise class on a limited basis (no running, stair climbing, etc.). I was doing my best, with the help of a friend, to plant the nearly 1,000 flowers I had either raised from seed or mail ordered for our yard this year. But emotionally I was now worse than blah. Things that needed to be done were not getting done. Inertia was taking over. So I tried the next new med.
It was a disaster.
I stuck with it for four days - and woke up earlier every day (I am talking about 4 AM - 3:30 AM - 3:00 AM). By the fourth day I was desperately fatigued but unable to stay asleep in spite of taking extra Trazodone at bedtime. I was starting to think of myself as Judy Garland - pills to sleep, pills to wake up ... so that was the end of that. Yes, even though I was tired I had been more focused for those four days - but I have to have my sleep!
My next pdoc appointment was on June 2. After I filled Dr. Meyer in, I asked whether Wellbutrin and Celexa could be taken together - looking for enhanced mood with a drug that might help with weight loss. He said they could, but had I forgotten how cranky I got on Wellbutrin? I had. He suggested we try adding Serzone. I reminded him that I had had constant diarrhea with Serzone when I tried it before. But how much, he asked, had I been taking? He looked it up: 300 mg. "No wonder!" he said. He explained to me that doctors have now learned that Serzone (Nefazodone) has to be introduced gradually to let the body get used to it. He gave me a couple of starter kits. These kits contain:
14 - 50 mg pills for the first week, to be taken morning and night
14 - 100 mg pills for the second week - for morning/night
4 - 150 mg pills for the next two days, for morning/night
Dr. Meyer suggested that I start even more slowly than that - cutting the 100 mg pills in half, increasing slowly to no more than 200 mg.
The improvement in mood was immediate.
I have now been on the combination of Celexa, Serzone and Trazodone for ten days. What a dramatic and wonderful difference! I feel much more decisive and in control. My to-do list gets shortened by about five items a day - which for me is incredible. I did notice occasional signs of going too far the other way - some poor judgment resulting in slightly TOO uninhibited speech - but having noted that mild hypomanic tendency in myself, I believe I can now curb it. I don't need as much sleep, so naps have been reduced. There were a few days where my appetite seemed to be increased, but this was sporadic. It appears I have actually LOST THREE POUNDS. Not much, I know ... but when I have held steady since late January, through both rigorous exercise and no exercise, three pounds is very exciting.
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