In 1993--and perhaps now, although I haven't researched it lately--the common feeling was that once you started antidepressants you should remain on them. However, I didn't feel comfortable remaining on drugs I didn't need. To me, it would have been like telling a diabetic to remain on insulin even if her blood sugar was normal without it.
But, as I mentioned in yesterday's post, in 1994 I had a third depressive episode and I was emotionally exhausted, so I agreed to remain on Zoloft for six months. I was now taking Klonopin as a sleeping pill because no matter how busy my days were, I couldn't fall asleep or remain asleep at night.
Even with the Klonopin, one night in February I was awake until 5:00 a.m., fell asleep for two hours, and got up at 7:00. The following material is excerpted from my eBook, Bipolar Depression Unplugged: A Survivor Speaks Out (This is copyrighted material; please do not reproduce it).
At 8:30 a.m., I dialed Pasha's (Ice Maiden) beeper number. She returned the call within moments. When I told her the problem, she said, "Stop the Zoloft. It has pushed you into a mania. You must begin taking lithium immediately. I will call in the prescription to your pharmacy. You need nine to ten hours of sleep each night because sleep deprivation feeds the mania."
"I can’t imagine feeling tired with all this energy‚" I said‚ fairly gushing into the phone.
"Susan‚ listen to me. You need sleep. How much Klonopin are you taking?"
"How many milligrams?"
"Double it. If you don’t fall asleep within the hour, take one more. If you are still unable to sleep, call me and I will prescribe a stronger medication."
"Okay," I answered in a subdued tone, somewhat concerned because she sounded worried.
"You will need to take blood tests for the lithium," Pasha said. "Make an appointment with Dr. Abcarian’s lab technician on Friday; I’ll fax the order to his office. The medication must be in your system for four days before we can get an accurate reading. I’ll see you on Monday at 3:30 If you need me before then, dial my beeper number."
Pasha’s tone suggested that our conversation was over so I hung up the telephone although I had no idea what the blood test was for. After taking two milligrams of Klonopin, I slept for a few hours, did some errands‚ picked up the lithium, returned home, and drove my minivan up our driveway and flattened the right front and rear tires against a small protruding lip of concrete that I’d circumvented for fifteen years. Within a half-hour, the Automobile Club tow-truck driver delivered my van and me to a tire store where they replaced the tires with new ones, and I returned home in less than an hour.
After a play date at a friend’s house, Alex (my son) came home from school. I had cleaned the house, done laundry, straightened his bedroom and had dinner cooking in the oven. We spent the next few hours playing Nintendo. He was pleasantly surprised by my increased energy level. Bernie (my husband) was delighted by my newfound interest in domesticity and we had a Norman Rockwell-like evening.
I slept five hours that night. The next day I bicycled in the morning‚ met a friend for lunch‚ went to the library, and had a manicure and pedicure at my favorite neighborhood nail salon. For dinner, I cooked roast chicken with mashed potatoes and creamed spinach. I made chocolate brownies and smothered them with ice cream‚ chocolate sauce, and whipped cream. Bernie was glad I had cooked, but was surprised by the high caloric content of the meal. Alex was thrilled. So was I.
By the third morning‚ after Alex and Bernie left the house‚ I crashed. That night and the next morning I had a terrible headache. I was nauseous, had diarrhea, and couldn’t stop urinating. I called Pasha’s beeper number.
"How many hours have you slept last night and the night before?" she asked.
"Five each night."
"Why didn’t you call?" she asked with reasonable annoyance.
"I took all the Klonopin you prescribed."
"We’ll switch to Ativan. I’ll call in a prescription to your pharmacy."
I described my other maladies.
"These are all medication-related and will go away in a few days," she said. "I will see you Monday."
After a brief nap‚ I felt great again. I caught up on some phone calls and joined a friend for lunch. After I came home‚ I gardened for a while before I was hit by the most severe headache I’d ever experienced. I spent the rest of the day in a semi-comatose position wondering anew why this illness was preying on me and whether it would ever end.
(to be continued)
Did your antidepressant medication cause your manias or hypomanias? Is there any antidepressant that's really worked for you? Did your doctor put you on a mood stabilizer before trying an antidepressant?