Another Horrible Week

My next post was supposed to be a continuation of the long list of drugs and experiences I'd had with those drugs during this ordeal.  I must, however, take a short detour with this post as it may have some relevant information to add.

My week started out this past Wednesday.  My doctor had prescribed Welbutrin, 150mg per day to address my severely, worsening depression and Prednisone as a third experimental trial to see if the previous results I'd had (see last post) would repeat themselves  The Prednisone dosage was to be as follows:  Day 1 - 60mg, Day 2 - 50mg, Day 3 - 40mg, Day 4 - 30mg, Day 5 - 40mg - Day 6 - 0mg, Day 7 - 40mg, Day 8 - 0mg, Day 9 - 40mg, etc.and to follow that dosing till I spoke to him.

The next afternoon, after having taken both medications my symptoms began to worsen.  Many of my old ME/CFS/Fibromyalgia symptoms that had been under control for about the last two months, came back with a vengeance.  I felt the all-over body pain creeping in and as the hours ticked by, they got worse.  I started to feel as though I had a fever (but of course I didn't actually) and coordination and energy dropped.  I was so depressed.

At first I thought that it may have been that I had missed a dose of Zoloft the night before.  When I had started taking the Zoloft (again) two months ago, my pain had mysteriously gotten much better.  My condition in general was better and all from a low 100mg dose of Zoloft it seemed.

I got back on track with the Zoloft and hoped to see a change after a couple days, but none came.  The pain and feverish feeling (on top of the already present weakness & fatigue) were getting worse if anything.

Then yesterday, I don't know what the hell happened.  I wondered if I had mistakenly gotten caffeinated coffee (a big no-no for me) that morning during my daily .5 mile walk to Dunkin Donuts because about an hour after I got home, the you-know-what hit the fan.  My mental state degraded, gradually escalated into a full-blown anxiety attack, complete with shaking limbs, heart practically beating out of my chest, that feeling that I was completely out of control and may just die any moment.  I couldn't talk to anyone or keep my mind on a single thought.  This lasted for hours (the severity waxing and waning) until I excused myself with an Ipod & headphones and locked myself into a room, lyed down on the bed, listened to Brahms and tried breathing exercises.  Oh yeah, I also took .5 mg of Ativan which is what I think finally brought me out of it for the most part.  As a result of my anxiety and just plain being out of my mind, I had missed a Prednisone dose (30mg).

The day wasn't over though.  My husband had flown in from LA that day after not having seeing me and our daughter for about six weeks.  We ordered pizza and sat down to eat.  I still wasn't feeling well and was not (to put it mildly) the life of the party but it seemed that the worst of my anxiety was over.  At one point I leaned my head over toward my husband's shoulder for some comfort.  The moment my head was down, my world began to spin out of control.  I'm talking full vertigo here - didn't know which way was up.  I also felt as though I would get sick at any moment.  I told everyone I needed to lay down and somehow stumbled to the couch as the worst of it was subsiding.  As I layed down, I still felt really dizzy and nauseated, but the spinning had stopped.  I remembered the missed dose of Prednisone and asked my mom to get it for me thinking I may be having withdrawal.  My dad took my blood pressure and it was 113/72 which is on the low side, but my pressure tends to be lower.  In about thirty minutes the dizziness got a little better and I was able to get up (with assistance) and be led slowly up the stairs to bed. 

The dizziness and subsequent nausea plagued me all night long.  When I got up to use the bathroom in the middle of the night I lost my balance and almost fell twice.  This morning, I don't feel too dizzy but weak and unsteady on my feet. 

I'll be calling my doctor as soon as his office opens.

Falling Further Down the Black Hole

My depression has reached a critical level. I don't give a crap anymore about trying a new diet, medication or anything for that matter. I haven't felt this low in a very long time. I physically feel terrible and there isn't much left in my life I have control over. I'm blessed to have a wonderful therapist who I've been keeping in regular contact with and who is closely monitoring my situation. I'm still taking about 10mg of Cymbalta per day and can't seem to lower he dose much more without suffering withdrawal.

I made the decision today that I will no longer be able to fulfill my responsibilities as manager here at the hotel. My cognitive impairment has gotten worse and worse. I spent quite a bit of time today on the phone apologizing to guests who apparently had made reservations but that I had no recollection of, or paper work on. I'm not used to making so many mistakes. I have often, in the past, held positions which required serious detail orientation, commitment and work ethic and are qualities I have always prided myself on. I guess those days are gone and hopefully only temporarily.

My marriage is seriously on the rocks and shows no sign of getting better. Now I'll be almost completely financially dependent on my husband and just the thought seems to choke off my air. My almost stubborn self-sufficiency is something I have also had pride in. There are some people I wouldn't mind having to depend on but my husband isn't one of them. I know he'll rub my face in it and it'll become a game of trade-offs. He pays for stuff so I'll have to do things for him in return. It's already that way to a large extent and will only get worse.

So, I'm not able to take care of my daughter, I'm not able to do my job and I'm not able to do things that need to be done to upkeep our home. What can I do? Not much.

I have yet to call the owners of the hotel to tell them I'll have to take a medical leave. That's going to be yet another humbling experience that I think I'll save for tomorrow.

Trying to Get Off Cymbalta?

The carb-free thing didn't work out but I'm not convinced that it isn't a diet issue that's causing my problems.  I've found some information on "delayed pattern food allergy" on the web and although I may be grasping at straws it sounds like an interesting theory to me.  I ordered a book by Dr. Gislason which explains the very involved process for discovering if you may in fact have a food allergy.  According to what I've read, it may take many months to come to any realization but if it works it's easily worth the time.

To prepare for fasting, which is the first step in the process, Dr. Gislason suggests that you rid your body of all prescription medications (as well as nicotine, caffeine & alcohol among other things).  I've been on SSRI's for about fifteen years to treat my Major Depression, so I'm a bit apprehensive about not taking them since I've experienced some severe depression in my life.  I've also had some experience with SSRI withdrawl so I know not to stop taking them abruptly.  I'm taking 60mg of Cymbalta once per day, so my plan was to take one dose every-other-day for a week or two then take one every third day, etc.  Since the medication comes in capsules, they can't be split in half.  I've used this method to wean myself off SSRIs before and have never had any problems.

Three days ago I intentionally skipped my Cymbalta dose before I went to bed, planning to take a dose the next night.  I woke up the next morning hardly able to move.  My muscles were so weak I could baredly lift my head from my pillow to drink some water.  As the day progressed I became more and more nauseated and I shivered with cold sweats.  It reminded me of my drinking days and the horrible hang-overs and alcohol poisoning I suffered all too frequently.  Unfortunately, my sickened state prevented me from realizing the source of my suffering until later in the evening.  I took a dose immediately but the damage was already done.  The next morning the withdrawl symptoms were gone.

I have NEVER experienced SSRI withdrawl symptoms that severe or sudden before.  In the past it's taken two or three days before I started to get "brain zaps" and feel dizzy or nauseated.  I admit that I was getting over a cold virus so that may have had some effect but I don't really think so.  My doctor prescribed 20mg tablets and I've been taking two of those once per day for the last two days and I haven't experienced any withdrawl as of yet.

If anyone out there is planning on quitting Cymbalta, be careful!  Also, don't let your prescription run out and think you'll just call your doctor tomorrow.  If you do, you may suffer severely for it and I wouldn't wish that on my worst enemy.

Am I Missing Something?

Either I've missed something major in my research or my cognitive abilities have been more compromised than I thought.  If anyone reading this post could offer some insight I may have missed I would really appreciate it.

For the past year and a half I've learned more than I care to about antidepressants (SSRIs, SNRIs, Trycyclic, etc.) and other forms of medication from pain killers to anti-convulsants and sedatives.  I've been prescribed about ten different medications (so far) by several doctors as I've tried desperately to get some relief from my illness.  Right now I'm taking 200mg Welbutrin, 60mg Cymbalta, 100mg Neurontin and 2mg Lorazepam once daily.

Actually, antidepressants are far from new to me.   I've been taking them for about fifteen years.  I've suffered with depression for as long as I can remember with my earliest memory of being depressed taking place in my second grade classroom.  But it wasn't until 1995, while I was attending college, that I was finally diagnosed  with Major Depression and medicated.  Since then I've probably taken most of the antidepressants on the market.

About eight years ago I developed severe Panic Disorder and started taking Lorazepam for acute attacks.  After my panic became partially controlled I used Lorazepam on occasion to help me sleep.  A year and a half ago when I became ill with Fybromyalgia my sleep was severely disrupted as it is with many sufferers.  I couldn't stay asleep and I was plagued with disturbing dreams and horrible nightmares.  I started taking the Lorazepam again and it magically helped me sleep without any noticeable side effects.        

OK so, here's where the confusion starts. The last two doctors I've seen have insisted that I stop taking Lorazepam due to it's "addictive" nature.  I've been prescribed other medications that are meant to replace it, the latest and greatest of which is Neurontin.  I took the prescribed dosage for about six weeks and never experienced any reduction in the side effects which were SEVERE and included nausea, dizziness, migraine headaches, confusion and excessive tiredness.

I'm not understanding the logic here.  Although Lorazepam is supposedly addictive, I've been taking it on and off for eight years.  When I do take it, I'm able to get a good night's sleep, wake up feeling rested and without side-effects.  I've gone days and even weeks in the past without taking it and never experienced any type of withdrawal (which I have from other medications).  The fact that Lorazepam is addictive seems beside the point in this case.  It has worked well for me consistently and I haven't had any ill effects that I'm aware of.  The same cannot be said about the drugs that have been prescribed to replace it.  What am I missing?  Is there some type of stigma attached to the prescribing of Lorazepam (Ativan) in the medical community?  Is it some kind of taboo?  I 'm thoroughly baffled and can think of no other reason that my doctors would be so adamant that I not take it.  Any insight on this?