Posted by Minnie-Haha on November 2, 2005, at 11:59:59
Haven’t checked-in in a while so I thought I’d give an update. First, my history: I am a 46-year-old, perimenopausal woman, overweight but active. Good marriage and two kids that I stress out about a little. (One lives at home and is “twice-exceptional” and the other is a grown man deploying for Iraq. Ugh!) My diagnoses are mild Bipolar Type 2 Disorder and OCD. I also have frequent neck and shoulder pain, and I take Zocor for high cholesterol.
In December 2004, after 15 months of anxiety, nausea, insomnia, and ultimately depression, I started Cymbalta at 30 mg daily. (I had been on a drug holiday when this year-plus illness started, but by the end I was trying – unsuccessfully – to manage it with benzos and a mood stabilizer.)
By mid-January 2005 I had been on 60mg Cymbalta for almost 4 weeks, was sleeping well and feeling great – but not manic – and was pain free. However, by mid-February, my appetite was a little too high (esp. for carbs), my motivation was a little too low, I was having some heart palpitations, and my blood pressure was up, so I dropped to 40 mg Cymbalta. My mood was OK, but I started noticing some aches and pains.
At the beginning of March, I started Bupropion 75mg to try to help with the appetite (had gained about 5 pounds) and amotivation. It didn’t help much, though I did feel more “activated” (got some songs stuck in my head, anxiety was back a little bit, wasn’t sleeping as well).
By mid-April I’d gained 10 pounds and had increased my night-time dose of Trileptal to help me sleep a little better. Mid-May I switched to Wellbutrin XL 200mg, which seemed a little “cleaner” than the Bupropion, but I was still sleeping restlessly 4-5 nights per week. Mid-June I switched to Wellbutrin SR 200mg, but that made me a little too jittery, so about the beginning of July I dropped to 150mg Wellbutrin SR.
I stayed on this combo – morn: 150mg Wellbutrin SR, 150mg Trileptal; eve: 40mg Cymbalta, 300mg Trileptal – but have had increasingly bad headaches and sweating the past couple of months, so went in to see my PCP yesterday. My blood pressure was 150/100! She wants me to lay off salt, get some extra potassium, monitor my pressure daily, and come back in one week. She wants to put me on a high-blood-pressure med, but I’m already on four meds, and, for cost and hassle reasons, am loathe to get on a fifth.
Any suggestions? I’m thinking about 1) dropping the Wellbutrin. If that helps lower the blood pressure, great. If not, 2) adding a beta blocker (don’t some work to augment antidepressants?). And if that works, 3) seeing if I can get back on 60mg Cymbalta, because I really miss how good I slept and felt at that dose. (My son deploys within the next month and I have felt it in my sleep in mood, even though I continue to take talk therapy.)
Any ideas would be appreciated.
Thanks,
Minnie
poster:Minnie-Haha
thread:574523
URL: http://www.dr-bob.org/babble/20051031/msgs/574523.html