My first med cocktail.

First post so I'll give a bit of background.

Several months ago I began to taper off of Celexa (40mg) (under guidance of a GP) because of drinking problems and other issues.  First taper I went to 20mg and about a week later starting experiencing anxiety/panic situations that I have never had before, even in stressful situations. So I went to 30mg and tapered down 10mg about every two weeks. During the tapering I was taking Prozac 20mg to help with withdrawals. Got down to 10mg Celexa but depression was terrible and had a panic attack before I was supposed to drive to my sister's rehearsal dinner with my father. Was prescribed Xanax to help through the wedding and it did help and I was able to be a groomsman and go to the reception.
Due to anxiety and not wanting to miss my sister's wedding, a few days before I got back on my full dose of celexa (40mg). Since the wedding I stayed at the full dose but I just didn't feel it was being as effective as before and had some anxious episodes as well.

Long story short, I decided to go see a psychiatrist and ween of celexa. During the initial session she gave me a Lamictal packet where I start on 25mg a day and gradually increase dosage to 100mg. During our next session (two days ago) she  prescribed Klonopin 1mg at night and Wellbutrin 75mg in the morning. She told me the goal was to take the Klonopin to help with Celexa withdrawal and the Wellbutrin for depression. She said she eventually wants me just on the Lamictal.

So for now I'm on Lamictal 25mg/day, Klonopin 1mg/day, Celexa 30mg/day, and Wellbutrin 75mg/day.  Talk about a cocktail!

Anyway, I would be extremely curious as to what Ryan would have to say about this combo and if he thinks my psychiatrist is on the right track. And of course I would love to hear anyone else's experiences with med cocktails.

Thanks!

[p4trick]

Is it possible to reach steady-state taking 1mg only once a day or should I be taking .5mg twice daily?

Thanks!

[heartfluttersflyawayplz]

you cant reach steady-state with taking it once a day needs to be twice a day, but am sure ryan can tell you this read back on a lot of ryans post and others you can see it needs to be twice a day.

[KevinNewYork]

yea read the topic i made about .5mg klonopin i am taking.  ryan has answered that question

[p4trick]

Thanks for the comments.

I just find it very disheartening that a "respected" psychiatrist wouldn't mention this when prescribing me Klonopin. When I go see my new therapist next week I'll ask him if he can recommend someone.

Glad I found this web site!

[p4trick]

Thanks so much for your comments, Ryan.

I was concerned about the Wellbutrin as well, since from what I understand it is an "activating" AD that would not help the anxiety (the same receptors that respond to cocaine?). And I also had told her about my heavy drinking and she kind of sound "wow" and maybe wrote something down. Not a peep about it since then. That set off alarm bells too since from what I've read alcohol and Wellbutrin are not to be mixed. I mean, the main reason I wanted to quit Celexa was that I drank like a fish (avg 18-24 beers a session.)

As for the Lamictal, I told her that I have racing thoughts on Prozac and maybe that is why she suggested a mood stabilizer. She told me she though I had some type of bipolar, I just don't remember the designation. She also said that the Lamictal has anti-depressant qualities and eventually wanted me on it exclusively.

Re: Klonopin, I've never had any anxiety issues until the first time I tried to wean myself off of Celexa and went from 40mg to 20mg. A week later I had an anxiety situation (completely out of the blue) where I started to feel stoned/spacey with nausea and the intense desire to get home and into bed. I also experienced what I can only describe as "existential" anxiety where I felt a deep sense of hoplessness and vulnerability in my own existence. I've been on AD's for about fifteen years but have never had to deal with anxiety before and I didn't truly understand how scary and debilitating it can be till I experienced it first hand.

Well, I guess I'll talk to my therapist about a new psychiatrist. What sucks is that I don't have insurance and just got through paying $250 for the initial session which took at most ten minutes (I didn't even fill out a medical questionnaire.)

Again, thanks for the reply Ryan.  You've been a great help.

[p4trick]

To clarify some things, she said she was prescribing Wellbutrin and Klonopin to deal with the withdrawals from Celexa and eventually have me just on the Lamictal. The only indication I gave to her was that while on Prozac I had racing thoughts. That was it. No talk of mania.

As for her being benzophobic, the first thing she mentioned was Xanax and then I said I'd heard of Klonopin and that was it. Klonopin it was.

Basically, all I want to do is get off Celexa without the episodes of anxiety and depression. Like I've mentioned before, I've never had the anxiety issues until coming off Celexa. Ever. I'm wondering since Celexa is sometimes prescribed for anxiety that withdrawing from it caused the anxiety?

I guess my main problem with my new psychiatrist is that she elicits a few responses from me and then starts prescribing stuff without really digging deeper into my history of depression or explaining the side-effects or that I need to avoid things like alcohol when taking a particular medication. It's basically about five minutes and then- bam, I'm out the door with new scrips.

[p4trick]

Ryan, I just wanted to see if you had any further comments after my follow-up posts.