Dear Lindsey:

I studied your thread this morning, reading all your posts. I will send you two posts this morning. The first will be about your psychiatric drugs take and the second about the rest. Please read and re-read the following over time, when you are calm so to best absorb some basic information and examine your drug intake past and currently.

You were diagnosed with major depressive disorder at 19 and twenty years later, at 39, you were diagnosed “as on the bi polar spectrum”. You’ve been taking a combination of Lithium and Vibryd for the last five years, currently 600 mg lithium and 40 mg vibryd. You also take Risperdal since recently, increased dosage a day ago. And you take or took very recently Klonipin as needed and Xanax as needed in the last five years.

In the past you took Zoloft for a few weeks and it “didn’t work” (19). You took another SSRI, Lexapro, for six years, 24-30, and it “worked for awhile but made (you) tired”. You then tried other SSRIs from 30-35. At 35 you noticed that your anxiety increased and at 37 or 38 you started having panic attacks. SSRIs from 37-40 “brought out more panic”. You used alcohol and marijuana as well and the latter increased your anxiety.

About lithium: as a medicine it is “primarily used as a psychiatric medication…If levels become too high, diarrhea, vomiting, poor coordination, sleepiness, and ringing in the ears may occur… Lithium salts are classified as mood stabilizers. How lithium works is not specifically known… Lithium is used primarily for bipolar disorder. It is sometimes used when other treatments are not effective in a number of other conditions, including major depression, schizophrenia, disorders of impulse control…The required dosage is slightly less than the toxic level, requiring close monitoring of blood levels of lithium carbonate during treatment… Those who use lithium should receive regular serum level tests and should monitor thyroid and kidney function for abnormalities, as it interferes with the regulation of sodium and water levels in the body, and can cause dehydration.. Very Common (>10% incidence) adverse effects of lithium include Confusion, Constipation.., Decreased memory, Diarrhea.. Dry mouth, EKG changes.. Hand tremor.., Headache..” -Wikipedia, “Lithium (medication)”.

About Vibryd: “Vilazodone, sold under the brand name Viibryd among others, is a medication used to treat major depressive disorder… Common side effects include nausea, diarrhea, and trouble sleeping… mania… It is in the serotonin modulator class of medications and is believed to work both as an SSRI and activator of the.. receptor…Vilazodone was approved for medical use in the United States in 2011… According to FDA staff, ‘it is unknown whether (vilazodone) has any advantages compared to other drugs in the antidepressant class… New warnings will be added to the Viibryd label related to a link between the drug and acute pancreatitis…Very common adverse effects (incidence > 10% Nausea, Diarrhea, Headache”- Wikipedia, “Vilazodone”.

About Xanax: “Alprazolam, sold under the trade name Xanax among others, is a short-acting benzodiazepine. It is most commonly used in short term management of anxiety disorders, specifically panic disorder or generalized anxiety disorder… Common side effects include sleepiness, depression, headache, feeling tired, dry mouth, and memory problems… Alprazolam is effective in the relief of moderate to severe anxiety and panic attacks. However, it is not a first line treatment since the development of selective serotonin reuptake inhibitors… Most evidence shows that the benefits of alprazolam in treating panic disorder last only 4 to 10 weeks”- Wikipedia, “Alprazolam”.

Regarding Klonipin, “Clonazepan, sold under the brand name Klonipin among others, is a medication used to prevent and treat seizures, panic disorder… It is a tranquilizer of the benzodiazepine class… Common side effects include sleepiness, poor coordination, and agitation”- Wikipedia, “Clonazepan”.

Regarding Risperdal: “Risperidone, sold under the brand name Risperdal among others, is an antipsychotic. It is used to treat schizophrenia, bipolar disorder… Common side effects include movement problems, sleepiness, dizziness, trouble seeing, constipation, and increased weight. Serious side effects may include the potentially permanent movement disorder tardive dyskinesia… Risperidone has shown promise in treating therapy-resistant obsessive-compulsive disorder, when serotonin reuptake inhibitors are not sufficient”- Wikipedia, “Risperdal”.

Now, my input: reads to me that the only possible success you had with psychiatric drugs is the Lexapro you took for six years, 24-30. I didn’t google it this morning, but from my knowledge it is an SSRI with quite a good reputation. The reason I say that the only possible success you experienced was with Lexapro is that you took it for six years, you kept taking it for long six years. And you stopped because it made you tired, and I guess you were tired of being tired.

Problem is, all the drugs you took after is making you tired as well, and sleepless, and some of their common side effects are distressing, increasing anxiety and the tiredness involved with anxiety. Seems to me that the combination of Lithium and Vibryd is not working well for you, as your anxiety and panic attacks are significant, currently and for a long time.

I suggest that you do re-read the above, take notes, think and bring your thoughts to your psychiatrist. Reads to me that it may  be better for you to get off the combination you are on (Lithium and Vibryd) and get back to Lexapro.

Lots of your distress, anxiety, panic is a result of these psychiatric drugs, so re-evaluate, with a psychiatrist the benefit vs harm that these are causing you currently.

Next I will submit the second post of this morning.

anita