introducing my happy cocktail

Those who read my blog often know that I see a psychiatrist and am on a cocktail of “happy meds” you’ll also know that I try to make light of my situation. The reason being that yes it does scare me that I have to rely on medication to be “normal” but I also blog about it so that others know that there is NOTHING wrong with admitting you need help and seeking out such help. Depression is REAL. Manic depression is severe and considered a disability. Looking for help does NOT mean that you are giving up or admitting defeat, it means you’re strong enough to take matters into your own hands and “fix” what is wrong.

I know that it’s hard for a lot of people to understand and there are still so many people out there that think depression is all in the mind (well duh…) and don’t believe it to be an actual condition and rather an excuse. Well to those of you who think that – wake up and smell the bloody sertraline!

I don’t regret it at all, being on my meds. I never will, because without it I KNOW that I don’t cope well without them and with all that’s been thrown my way I’d probably be in a box without them. I have made some stunning friends with people who have the same “issues” and I will admit that it has been great knowing them and chatting to them. Not that my “normal” friends are beyond understanding but it equates to a non-parent giving a parent advice and empathy – just not quite right.

So when I started seeing a psychiatrist I was prescribed 50mg of sertraline to start on and see if it helped. After about 2/3 months I plateaued and the dosage needed to be increased and so it kept being increased to where I am now with the addition of 20mg Ritalin to it. Unfortunately I am currently on the highest dosage of sertraline and therefore it can’t be increased, I could change over to another but then we have to start from scratch and we have no idea how I would react to it. So instead we added lamotrigine. My current cocktail is 200mg of Sertraline, 200mg of Lamotragine and 20mg of Ritalin and it seems to be the keeper for now.

As with everything in life there are pro’s and con’s. and in order to educate you all (and myself a bit) I thought I’d give a bit of a definition of each drug I just mentioned as well as the side effects it could possibly have (note that when negative side effects display Dr obviously stops the meds for another)

SERTRALINE

Sertraline hydrochloride (trademark names Zoloft and Lustral) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It was introduced to the market by Pfizer in 1991. Sertraline is primarily used to treat major depression in adult outpatients as well as obsessive–compulsive, panic, and social anxiety disorders in both adults and children.

The efficacy of sertraline for depression is similar to that of older tricyclic antidepressants, but its side effects are much less pronounced. Differences with newer antidepressants are subtler and also mostly confined to side effects.Sertraline is highly effective for the treatment of panic disorder, but cognitive behavioral therapy in combination with sertraline is a better treatment for obsessive-compulsive disorder than sertraline alone. Although approved for social phobia and posttraumatic stress disorder, sertraline leads to only modest improvement in these conditions. Sertraline also alleviates the symptoms of premenstrual dysphoric disorder and can be used in sub-therapeutic doses or intermittently for its treatment.

Among the common adverse effects associated with sertraline and listed in the prescribing information, those with the greatest difference from placebo are nausea, ejaculation failure, insomnia, diarrhea, dry mouth, somnolence, dizziness, tremor and decreased libido. Those that most often resulted in interruption of the treatment were nausea, diarrhea and insomnia. Sertraline appears to be associated with microscopic colitis, a rare condition of unknown etiology.

LAMOTRIGINE

Lamotrigine is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. It is also used as an adjunct in treating depression^[though this is considered off-label usage.^[ For epilepsy, it is used to treat focal seizures, primary and secondary tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome. Like many other anticonvulsant medications, Lamotrigine also seems to act as an effective mood stabilizer, and has been the first U.S. Food and Drug Administration (FDA)-approved drug for this purpose since lithium, a drug approved almost 30 years earlier. It is approved for the maintenance treatment of bipolar type I. Chemically unrelated to other anticonvulsants (due to lamotrigine’s being a phenyltriazine), lamotrigine has many possible side-effects.

As of December 2010, lamotrigine carries an FDA black box warning for aseptic meningitis.

Side-effects include loss of balance or coordination, double vision, crossed eyes, blurred vision, dizziness and lack of coordination, drowsiness, insomnia, anxiety, vivid dreams or nightmares, dry mouth, mouth ulcers,^{[citation needed]} memory and cognitive problems, mood changes, runny nose, cough, nausea, indigestion, abdominal pain, weight loss, missed or painful menstrual periods, and vaginitis. The side-effect profile is different for different patient populations

In rare cases, lamotrigine has been known to cause the dangerous drug eruptions DRESS syndrome, Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) and has been associated with a decrease in white blood cell count (leucopenia) and carries an FDA black box warning for aseptic meningitis.

METHYLPHENIDATE

Methylphenidate (Ritalin, MPH, MPD) is a psychostimulant drug approved for treatment of ADHD or attention-deficit hyperactivity disorder, postural orthostatic tachycardia syndrome and narcolepsy. It may also be prescribed for off-label use in treatment-resistant cases of lethargy, depression, and obesity. Methylphenidate belongs to the piperidine class of compounds and increases the levels of dopamine andnorepinephrine in the brain through reuptake inhibition of the respective monoamine transporters. Thus, Methylphenidate possesses structural and pharmacological similarities to cocaine, though MPH is less potent and longer in duration.

Some adverse effects may emerge during chronic use of methylphenidate so a constant watch for adverse effects is recommended.^[41] Some adverse effects of stimulant therapy may emerge during long-term therapy, but there is very little research of the long-term effects of stimulants. The most common side effects of methylphenidate are nervousness, drowsiness and insomnia. Other adverse reactions include:

Abdominal pain, Akathisia (restlessness), Alopecia (loss of hair), Angina (chest pain), Appetite loss, Anxiety, Blood pressure and pulse changes (both up and down), Cardiac arrhythmia, Diaphoresis (sweating), Dizziness, Dyskinesia, Euphoria, Headache, Hypersensitivity (including skin rash, urticaria, fever, arthralgia, exfoliative, dermatitis, erythema multiforme, necrotizing vasculitis, and thrombocytopenic purpura), Lethargy, Libido increased or decreased, Nausea, Palpitations, Pupil dilation, Psychosis, Short-term weight loss, Somnolence, Stunted growth, Tachycardia (rapid resting heart rate), Xerostomia (dry mouth)