November 21, 1999 - Six months after diagnosis
Six months ago, Dr. Meyer had put me on Celexa, and his observation of my subsequent behavior, combined with some other things in my history, led to the diagnosis of Bipolar Disorder.
For six months we have been trying to find a combination of medications that would combat my depression, NOT induce mania, and neither make me gain more weight nor prevent me from losing weight. Nothing has worked.
This is, I tell myself, a common process. You try something. You learn from it. You try again. Each failure tells the doctor something. Sooner or later, something has to work. But it's hard on you, all the same.
The last medication change was to cut my dose of Wellbutrin from 150 to 75 mg per day, in case this drug was causing the puffy swelling in my hands. After two weeks of this, I noticed two things:
- My hands were still swollen, and
- I was getting even more depressed.
The first two weeks on this combination, which also included Zoloft and Zocor, I lost 7 pounds, which was outstanding - but my depression got much worse. I found myself becoming uncommunicative, neglectful of responsibilities and listless. On the Sunday and Monday before my November 16th doctor's appointment, I just spent most of the day and evening reclining on the couch watching movies on TV and videotape.
It was apparent that Wellbutrin just doesn't get the job done for me. Zyprexa must have been helping with mood, but is no longer an option due to the weight issues. After talking all this over, Dr. Meyer and I discussed putting me back on Celexa. Emotionally I had felt best on Celexa of anything we have tried, but after five or six weeks on it I was, as noted, exhibiting manic symptoms, including having trouble staying asleep. Here we made a mistake: I misremembered the medication history, and said to the doctor that we had not yet tried Celexa with Trazodone. I thought I had only taken Celexa with Klonopin. Looking back over my articles, I now discover that the actual prescription was Celexa, Klonopin AND Trazodone. Damn!
Anyway, the new medication regimen is: 1/2 tablet of Celexa (10 mg) during the day and 50 mg Trazodone at bedtime (plus Zocor for cholesterol).
I've been on this meds schedule for five days now, and it isn't working. A hard kick in the teeth late Thursday from one of the companies for whom I do freelance work made things worse, in fact. Now the depression is only slightly better, and quite frankly I'm not sure whether that is to do with the Celexa or my own willpower. Worse yet, I gained BACK two pounds. I hope it's just due to the time of the month.
Dr. Meyer made me promise to call him with a progress report, especially if I didn't feel any better. It's a good thing he did that, because I don't want to talk to anybody! As it is, he will be hearing from me in a day or two.
Next: Bah, Humbug!
