Stay on med or get off?

[lalowe]

After a major life trauma in 1991, I suffered what was probably post-traumatic stress disorder.  It was a VERY distressing time, but after a year of therapy, exercise, meditation, and a good diet, I was doing very well.  However, after every major life change - moving, etc., I've gotten depressed/anxious again.  I started paxil in 1993. It helped quite a lot.  I tried to get off in 1996, but stayed off only about 4 months before getting back on.  

I got off succesfully in 2001 for about two years until the birth of my daughter. I had a bad case of PPD, and started taking it again.  I also took Klonopin on the rare occasion, but found that it helped tremendously when I did.  AFter 8 months, I tried stopping the Paxil, but began to feel very depressed again.  Because the paxil was causing sexual side-effects, my gynecologist and I decided to try Wellbutrin 300xl instead.  Initially, it helped a great deal.  We moved recently, and I started a new job, and the anxiety has been almost unbearable and I am depressed, too.  What's worse is that I'm having a lot of difficulty sleeping.  

I feel that I definitely need to get off of Wellbutrin because I think it's aggravating the sleeping problem and doing nothing for anxiety.  I'm worried that continued use of any of these medications might be preventing my brain from ever being able to regulate my brain chemistry on its own and that the more I take them, the more likely it is that I'll never get off. I realize that these drugs are not "addictive" in the usual sense, but I wonder if dependency is likely. I'm strongly considering stopping all medication and working very hard to manage with exercise, diet, and meditation, maybe keeping some Klonopin on hand for the worst days. However, I think I may go through up to a year of depression before things get better.  It's hard to be motivated to stick with these habits when I'm depressed, and I am worried about whether I can actually do it. I have recently read that some dietary supplements like magnesium and some amino acids can make a big difference. I have talked to many therapists over the years (only 1 in 5 has been helpful), but have never had an actual psychiatrist evaluate my drug treatment or consider my mental health history.  I would like to do this, but can't seem to get an appt. directly with a psychiatrist. I don't have a regular dr. in town yet, and hate to pay for a visit just to get a referral, and I don't want to get one who will just change my meds. I don't really have any support in this except my mother who lives in another state.  My husband is understanding, but not talkative.

So,
1) How possible is it that continued drug therapy will result on lifetime dependency?
2) Could Wellbutrin be contributing to my anxiety/insomnia?
3) What do you think of alternative treatments for depression as opposed to drug therapy?  I'm pretty conservative about alternative medicine, but I'm open. How do a find a dr. open to this?

[Roger Gould, M.D.]

Good questions. Wellbutrin should not be causing anxiety and insomnia, and a little klonopin every so often is find. You should definetly see a psychiatrist for a complete evaluation, and also to help you talk through your depression while going off , or changing drugs.  You  don't want one who just manages your medications.  Try the university hospital nearest to you, and ask for the department of psychiatry, and a referral to just the kind of psychiatrist you need.  That's better than trying to figure this out on your own.

[scottkj]

I am not a DR. nor an expert on this topic.  In fact, I was only diagnosed with GAD a few weeks ago.  
SSRI and other anti-depressants work well for a lot of people, but one I tried, Lexapro, resulted in very bad side effects (excitement, disconnected feelign, waking up several times at night disoriented, and even fainted briefly).  These were not symptoms that I had before taking the medication.


I am going to try alternative Talk/Cognative therapy with a Psychologist.  I also take XANAX 1MG XR per day, but plan to wean down to .5MG XR per day and see how I do.

Scott

[scottkj]

Follow-up...Improvement for me


I tried Lexapro and had really bad side effects.  I did not stay on it very long as the side effects scared the heck out of me.  I also took and am taking 1MG Xanax XR per day for anxiety.
My goal is to get control of my panic and anxiety so that it does not rule my life.

I went to see a counselor and Psychiatrist.  My Psychiatrist just kept prescribign medications for anxiety, my counselor actually helped me talk things out and get to some of the issue that may be causing my anxiety.  Along with the in office therapy, she suggested I read the book called "Don't Panic" by R. Reid Wilson, PH.D.  The book teaches you how to deal with and ultimately face your anxiety and panic attacks head on.  The techniques including daily relaxation, positive talk during anxious times and relaxation at the time of anxiety.  It builds on providing the ability and skills to invite panic head on and deal with it.  The theory is that if you avoid it, it will always come back.  If you face your fears and deal with them adaquately, then panic subsides.  The book has worked really well for me.  I am going to try next week to taper off the XANAX and slowly go back to a medicine free existence.  

I am not a DR. and cannot recommend this in place of medications.  I just choose to try to conquer my fear of panic with out drugs.  I highly recommend this book which you can purchase for about $9.00.  I has helped me a great deal.

[hangin'in there!]

This is excellent advice Doctors!! I'm with the medhelp. response to your problem.  It's very important to be correctly evaluated by an expert - not just drugged by one.  Take this answer as the best $5 you ever spent, it really was quality advice.

[leigh47]

I just wanted to wish you luck with your medical evaluation.
It is a good idea.  I don't want to disagree with the doctor, but I was on Wellbutrin for 5 years and it caused insomnia and anxiety. I was on Ambien to counteract the insomnia. Wellbutrin is a "stimulating"  antidepressant, unlike serzone which is more sedating. For some people, this can be a problem.

I am trying alternative methods as well. Exercising and relaxation techniques and therapy. I am trying to wean myself off Ambien after 5 years. I went to my psychiatrist who now wants to put me on low dose of Seraquel...which I think has way too many possible dangerous side effects.

Good luck and I wish you the best.