Medications offer a chance of improvement, but as most anyone who has tried a psychiatric medication can likely attest: it can be hard to find the right one for you. The process can take years and be disheartening at times. Taking medications is a gamble. We risk disappointment and side effects ranging from minor to severe in order to potentially reap the rewards that medication can offer. Medication is a critical tool in the management of mental illness for many people. However, the process of finding the right medication and complications that can arise from taking medications deter some of us from trying.
This morning I took my first dose of a new (to me) medication. I have tried over 15 psychiatric medications, among which very few have had the desired result without unbearable side effects. To say that this morning’s pill was a hard one to swallow, would be painfully accurate. I’m anxious. I’m trying my best not to read in to every little thing I’m perceiving in my body and mind. You know that feeling when someone says they have lice and you start itching your scalp? Reading the list of potential side effects of a medication can cause a similar sensation. In an effort to calm down, I’m trying to remember why I’m taking this risk, and I thought I’d share that with you.
Early this summer I stopped taking all of the daily medications I had been previously prescribed. I decided to reduce the dose of each of them, one at a time, in order to see if I felt any difference with or without them. The result seemed to be that none of the medications I was taking were having any positive effect on my mood. In one case, reducing and then eliminating one of my medications from my regimen seemed to pull me out of my brutal two-year-long depression. I had been prescribed all of the medications I was taking over a short period of time, so I hadn’t been able to isolate the impact of each medication. Starting back up from zero felt like the right decision. Once I was free from daily medications, I was faced with a choice: start trying a new medication or take a break. I took a break.
The break has been wonderful. It has given me the opportunity to rest my body – free from the side effects of medications and symptoms of beginning and ending medications. For two years I had felt like a guinea pig – constantly trialing something new and coming off of something else. Trying 15 medications in two years was taxing on my body and mind. I tend to be sensitive to changes in psychiatric medication, experiencing headaches, stomach upset, brain zaps, nausea and negative mood changes, among other side effects. In a couple of cases I have had to immediately stop taking a medication because of potentially severe side effects (a rash with Lamotrigine & a dramatic increase in suicidal ideation with Mirtazapine). I’ve had to stop taking Venlafaxine, Desvenlafaxine and Clonazepam, leading to horrible withdrawals. In all of this I’ve found one medication that works for me without any major side effects, the afore mentioned Clonazepam. While I’ve had to stop taking it daily due to concerns around dependency, I continue to use it infrequently on an as-needed basis to help manage my anxiety and panic. One medication, out of at least 15, has been helpful in a lasting way. Taking a break from trying new medications has given me the chance to escape from the pressures of trying medications, and the disappointment when the gamble doesn’t pay off.
I knew, of course, that I would have to make the choice between continuing to manage my illnesses without daily medication or trialing new medications again. Would I continue to avoid new medications and eliminate the possibility of finding a medication that helps? Or keep trying medications in spite of my terror of putting my body and mind through uncertain changes again? Ultimately, I know I don’t want to cut out the chance of finding a method of treatment that could make the weight of these illnesses easier to bear. Yesterday, when my psychiatrist again suggested I try Moclobemide, I agreed. She first suggested this medication to me months ago, and I’ve been giving one reason or another (with the prevailing reason being my anxiety about beginning medication trials again) for why I didn’t want to start taking it yet ever since. Now, in the beginning phases of a depressive episode, after months of rest, I decided it was time.
Moclobemide is an antidepressant in a different medication class than any I have taken to date. It tends to be weight-neutral (a major plus for me as I struggle with weight gain), low on side-effects and has been seen to improve social anxiety for some individuals who take it. I took my first pill this morning. It’s time to hold my breath and hope this gamble pays off.