2001 was a busy year for me. After working from home since 1997, I took a day job as a favor for a friend; I traveled to Florida over the Fourth of July (HOT!) and to California in September, our return delayed till four days after the 11th. Oddly, perhaps, there were few medication changes that year, but in 2002 all hell broke loose.
Late May 2001:
Medications:
• Trazodone 25 mg
• Celexa 20 mg
• Serzone 250 mg
• Lorazepam .5 mg (as needed)
Comments and Complications: I requested an increase in Serzone after realizing significant depression had returned. There was some improvement, but not enough. Note: Amitriptyline (Elavil) was tried to improve sleep and help fibromyalgia, but instead I slept very badly and this medication was abandoned after one night.
Late June 2001
Medications:
• Trazodone 25 mg
• Celexa 20 mg
• Serzone 300 mg
• Lorazepam .5 mg (as needed)
Comments and Complications: I requested another increase in Serzone. Significant improvement occurred, although patient experiences mild problems with diarrhea when stressed. Fibromyalgia flares have been occurring for several months. Other significant notes: I am taking 100 mg Serzone in the morning, with Celexa, 200 mg Serzone at dinnertime, and Trazodone plus an antihistamine (only) at bedtime. Moving Serzone to dinnertime instead of bedtime and switching to antihistamine instead of a combination OTC drug that included pseudoephedrine has resulted in much better sleep.
February/March 2002
Medications:
• Trazodone 25 mg
• Celexa 20 mg
• Serzone 300 mg
• Lorazepam .5 mg (as needed)
• Depakote 250 mg (Discontinued)
• Zyprexa 2.5 mg (Discontinued)
Comments and Complications: Because of an increase in anxiety and racing thoughts, Depakote and Zyprexa were added. Zyprexa was dropped almost immediately as being too sedating. Depakote was continued for two months. The anxiety eased; however, I was concerned about the weight-gain side effects of Depakote and requested discontinuation. The anxiety did not return.
August 18, 2002
Medications:
• Trazodone 25 mg
• Celexa 20 mg
• Serzone 300 mg
• Lorazepam .5 mg (as needed)
• Naproxen 550 mg (twice daily, for fibromyalgia)
Article: Changes Without Change - Catching Up
September 19, 2002
Medications:
• Trazodone 25 mg
• Lexapro 10 mg
• Serzone 200 mg
• Lorazepam .5 mg (as needed)
• Naproxen 550 mg (twice a day, for pain)
Comments and Complications: Lexapro is a new, more concentrated version of Celexa, supposedly with fewer side effects, so I switched to this medication at first opportunity, while reducing Serzone to compensate.
October 14, 2002
Medications:
• Trazodone 25 mg
• Lexapro 10 mg
• Lorazepam .5 mg (as needed)
• Naproxen 550 mg (as needed for pain)
Comments and Complications: I reported significant agitation and hypomanic behavior by phone; Serzone was dropped immediately and I will see doctor in eight days.
Article: Lexapro and Go Go GO!
October 23, 2002
Medications:
• Trazodone 25 mg
• Lexapro 5 mg
• Celexa 20 mg
• Lorazepam 1 mg
• Naproxen 550 mg
Comments and Complications: Due to continuing mental and physical agitation, Lexapro dosage was cut in half, some Celexa added back in, and 1 mg Lorazepam was added to the nightly dose of Trazodone to improve sleep. Lorazepam dosage is to be titrated down to nothing as possible, Celexa reduced and Lexapro titrated back up.
Half a Lexapro is Better Than None
November 22, 2002
Medications:
• Trazodone 25 mg
• Lexapro 10 mg
• Lorazepam 2 mg
• Naproxen 550 mg
Comments and Complications: I seemed to be doing okay on this mixture except for trouble sleeping, so Lorazepam was temporarily increased.
December 29, 2002
Medications:
• Trazodone 25 mg
• Lexapro 15 mg
• Lorazepam 2 mg
• Naproxen as needed
Comments and Complications: Shortly before Christmas, my doctor ordered me to get more sleep by going to bed at a regular time. However, serious episodes of exhaustion and depression caused me to increase Lexapro to 15 mg just to get through the holidays. When exhaustion and depression recurred after Christmas, I saw family doctor (during psychiatrist's vacation) who recommended keeping Lexapro at 15 mg. Rapid cycling followed, from "okay" to anxious depression to weeping depression to okay.
Article: Clutter, Christmas and Mixed States
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
