On October 2nd my psychiatrist increased my Celexa dosage from 30 to 40 mg daily, moving it also from morning till bedtime, and doubled Wellbutrin SR from 100 to 200 mg per day. At that time I had reported to him significant symptoms of depression. He also advised me to increase my time on the job - I had been building up toward returning to work full time ever since August lung surgery.
The week of October 6th I worked every day for the first time. I was quite tired over the following weekend, but no longer felt guilty about not getting anything much done. I just rested. Then on Monday and Tuesday I felt GREAT! Hypomanic! I even volunteered to make dinner Monday night, something I almost never do, because I am not much of a cook, and everything I do know how to make is very fattening. Then Tuesday night, the 14th, I crashed into exhaustion that lasted several days. When I saw my pdoc on the 16th, I told him, hands flying through the air in gestures, that I was better but my state of mind shifted rapidly during the days depending on whether I was tired at the time or not.
He prescribed another mood stabilizer to go along with Trileptal - Topamax. He started me out on 25 mg at bedtime and said if I noticed no side effect problems to increase to 50 mg in a week. To avoid any tendency toward imagining symptoms, I deliberately did not look up the side effects of Topamax. I noticed nothing out of the ordinary, and increased the dosage on schedule.
Now I started to see a more steady upward progress. I began to use my journal more effectively for goal setting and planning. I now head each journal page with the four major problems I need to overcome. They started out:
- Too fat
- Too tired
- Too messy
- Not getting things done
I also started using lined sticky pads for lists and goals. For example, in my office, the most difficult room of all on my "too messy" list, I stuck a note to the wall with my vision of the office as I want it to be: "Everything is put away. It gleams. Ornaments attract the eye. My work table is organized without clutter; so is my desk. The floor is clear. I know where everything is. I know where everything goes. I can keep it clean with five minutes' work." That note is my goal and my inspiration.
My next visit to the pdoc was on October 30th. He praised my development of my own cognitive techniques. We discussed tricks to keep me off snacks in the evening. He asked me what would be a good substitute for chocolate, and without hesitation I said, "Coffee!" So now I'm having coffee (half decaf) in the evening after dinner - when I remember. It works quite well to keep me away from chocolate!
At that same visit, Dr. Meyer raised Topamax to 75 mg a night and changed from 200 mg Wellbutrin SL to 300 mg Wellbutrin XL in the morning.
After this change I began having trouble getting up in the morning - sleeping through my radio alarm, dragging after I did get up. I had to switch from radio to beep beep alarm because the radio was too easy to ignore. I tried leaving Lorazepam (generic Ativan) out one night, but that was terrible. I must have awakened 20 times during the night, every time I turned, just a momentary waking but enough to make my sleep completely unrestful. Last night I reduced Trazodone to 1/4 tablet - about 12 mg or less - and noticed no difference at all in my sleep.
I saw Dr. Meyer this morning, and now have the fifth medication change in eight weeks. We are going to try dropping Trazodone altogether, and I am to take 25 mg of Topamax in the morning while continuing 75 mg at night. If this makes me drowsy during the day, then I change to taking the entire 100 mg at night. Both the doctor and I are very pleased with the results of my seeing him more frequently than before. Let me take this opportunity to thank EricaHOST, who urged me to make that change!
Bottom line: I'm improving. And oh, yes - at last weigh-in, I had lost four pounds. Hooray!
| Medications and Supplements Today | |
| Morning | Bedtime |
| Bipolar Disorder Meds: Trileptal - 150 mg Topamax - 25 mg Wellbutrin - 300 mg
Other Meds:
Supplements: |
Bipolar Disorder Meds: Trileptal - 150 mg Topamax - 75 mg Celexa - 40 mg Lorazepam - 1 mg
Other Meds:
Supplements:
Other: |
