What should I do with my meds

[MidnightDream]

I've been on sertraline for almost 6 weeks now (friday), dose is only 50mg. I'm diagnosed autism & bpd.
So far I have noticed...

Good things
Way less anxiety
Generally less irritable

Bad things
Insomnia !!!!!!!!
Mood swings have increased in intensity and in length
A lot more suicidal thoughts & ideation - I never really truly considered acting on it before unless I was intoxicated. Now I'm doing it sober.

My doc wants to try me on 100mg, to see if it'll help with the mood swings - I'm asking you lot with absolutely 0 medical knowledge, what do you think I should do?

A) Try the 100mg for 2 weeks, embrace the potential for chaos
B) Stay on 50mg for another 2 weeks, ask for sleeping pills to help the insomnia
C) Ask to try a different medication entirely

Aaaaaand... Go!

 

[Himalayan]

B. My suicidal ideation spiked up by 200% at first too, but it went away, after some time

 

[SectOfValtiel]

maybe all of the above
try to stick to the 50 with the help of some sleeping pills if you can, if the problems persist see how 100 goes
and if the problems get worse to the point its an active detriment, try something else instead
seems like different meds work for different people to varying degrees so
theres always going to be some level of trial and error until you find what truly works for you

and hell, i say that as someone that has had mostly bad experiences with my meds
got sent to the ER twice, have been on a dozen different antidepressants- most of which either did nothing, or made it actively worse
and even when i found pills that helped they only lasted a few weeks before it trailed off completely
i was actively seeing my doctor every week for over a year before i got frustrated and quit all my meds cold turkey... but i wasnt working with a therapist for most of that, id quit after dealing with a pretty shitty one the year before
now im only really working with a therapist but
i have a new diagnosis (bpd) and im learning theres likely more i dont know about too, and i think approaching this from the perspective of psychology rather than a medial one might be better for me
i was considering asking for a psychiatrist instead to see if that could help

but thats just my experience/thoughts
i hope you find something that works better for you

 

[Regen]

Difficult. Is it the first Antidepressant you test?

I took Sertralin many years and it helped me. But my moods calmed down. Only the sleepness nights were a big problem. At the end I took a second medicine for sleep. I dont like it, but no chance without. Bad sleep is not good for depression. I took quetiapin for sleep. Sometimes trimipramin.

But If you feel more suicidal, thats dangerous. When I was a Teen I get a medicine and I was more suicidal then. If you are younger this can happen. Maybe I would try another medicine. Not because of the sleep but because of the moods and the suicidal thoughts.

Can you talk about this with your doctor?

 

[farFSightcloseTHart]

Hello. I dont know your situation and Im very noob in the topic, just started learning about psy drugs. That being said, I (think) know that ssris are only helpfull in autism for anxiety symptons which you are already beneficting from as you say. And you are also experiencing some side effects, the insomnia and increased suicidality. As for mood swings i dont know what that exactly means. SSRIs can also exacerbate/induce hypomania in bpd and also make you more irritable incially, in any person (not sure how long that lasts or supposed to last). In pbd is used to treat only the bipolar depressive symptoms and carefull should be taken therefore for you not to go hypomanic/maniac. Also it may take more than 6 weeks for its full antidepressive effects.
So... I wouldnt increase the dose. As for change in medication I cant say, but i think its best to make sure you dont like a drug so you can learn from it since youre already on it, before jumping to another one. I think suicidality is common before ~25yo on ssris, i think the exacerbating effect of the drug on this should pass, 6 weeks is not that long on the med.

 

[MidnightDream]

B. My suicidal ideation spiked up by 200% at first too, but it went away, after some time

How long did it take?

Difficult. Is it the first Antidepressant you test?

I took Sertralin many years and it helped me. But my moods calmed down. Only the sleepness nights were a big problem. At the end I took a second medicine for sleep. I dont like it, but no chance without. Bad sleep is not good for depression. I took quetiapin for sleep. Sometimes trimipramin.

But If you feel more suicidal, thats dangerous. When I was a Teen I get a medicine and I was more suicidal then. If you are younger this can happen. Maybe I would try another medicine. Not because of the sleep but because of the moods and the suicidal thoughts.

Can you talk about this with your doctor?

Yeah, it's the first medication I've ever been on. I'm not crazy young, early 20s, the lack of sleep is definitely becoming an issue, I'm thinking of asking for sleeping pills regardless of whether I up my dose this week or not, I'm just so exhausted and I definitely think that's making the depressive episodes and then obviously the suicidal thoughts on top much worse, but I could be wrong.

Gonna have a chat with her on friday, just trying to decide on how I want to proceed before that appt really

Hello. I dont know your situation and Im very noob in the topic, just started learning about psy drugs. That being said, I (think) know that ssris are only helpfull in autism for anxiety symptons which you are already beneficting from as you say. And you are also experiencing some side effects, the insomnia and increased suicidality. As for mood swings i dont know what that exactly means. SSRIs can also exacerbate/induce hypomania in bpd and also make you more irritable incially, in any person (not sure how long that lasts or supposed to last). In pbd is used to treat only the bipolar depressive symptoms and carefull should be taken therefore for you not to go hypomanic/maniac. Also it may take more than 6 weeks for its full antidepressive effects.
So... I wouldnt increase the dose. As for change in medication I cant say, but i think its best to make sure you dont like a drug so you can learn from it since youre already on it, before jumping to another one. I think suicidality is common before ~25yo on ssris, i think the exacerbating effect of the drug on this should pass, 6 weeks is not that long on the med.

Yeah, I don't know how helpful they are with regards to personality disorders, there's not really a specific medication for those and its mostly just trial and error. In terms of mood swings, I experience quite significant highs followed by really low lows and it cycles, I've definitely noticed these worsening since starting the meds which concerns me the most tbh.

 

[Himalayan]

How long did it take?

Yeah, it's the first medication I've ever been on. I'm not crazy young, early 20s, the lack of sleep is definitely becoming an issue, I'm thinking of asking for sleeping pills regardless of whether I up my dose this week or not, I'm just so exhausted and I definitely think that's making the depressive episodes and then obviously the suicidal thoughts on top much worse, but I could be wrong.

Gonna have a chat with her on friday, just trying to decide on how I want to proceed before that appt really

Yeah, I don't know how helpful they are with regards to personality disorders, there's not really a specific medication for those and its mostly just trial and error. In terms of mood swings, I experience quite significant highs followed by really low lows and it cycles, I've definitely noticed these worsening since starting the meds which concerns me the most tbh.

About a month, i think

 

[Cathy Ames]

Please make sure to tell the doctor about the increased suicidal ideation (and the other stuff too, of course).

 

[western_heart]

it sounds like you are experiencing SSRI-induced hypomania. This is a known side effect, but some medical providers are unaware or bad at recognizing it. I was misdiagnosed as bipolar for years as a result. I question your doctor's expertise if they want to increase the dose in response to insomnia + mood swings! Most likely they have no idea what they are doing. I'd think a lower dose would reduce the insomnia and mood swings. Whatever you decide to do about the drug, I suggest getting a better doctor if you can.

I was prescribed sertraline multiple times and the most memorable time, I would stay up for days, making impulse decisions, spending crazy amounts of money, traveling thousands of miles. I even bought a new car on a whim. It was worse at higher doses, but I still had issues even at 12.5 mg (half of a child's dose.) The doctors I was seeing wanted me to keep taking the drug and then gave me additional prescriptions to try to manage the hypomania. When I stopped I would get incredibly suicidal and nonfunctional. Not all doctors are aware of the potential withdrawals either (euphemistically called SSRI discontinuation syndrome)... I tapered off on my own a few times, but the very last time I tried sertraline, I stopped it by switching over to prozac for a week since it has a longer half life. I have similar effects on similar drugs (other SSRIs and SNRIs) as well.

For BPD - a mood stabilizer like lamotrigine might help, either on its own or in combination with sertraline or another antidepressant. I was first prescribed lamotrigine when they thought I was bipolar, and have been on it for almost a decade now. I am not diagnosed with BPD but I identify with the label enough to follow r/BPD and r/BorderlinePDisorder, and lamotrigine seems well regarded on there.

 

[Himalayan]

it sounds like you are experiencing SSRI-induced hypomania. This is a known side effect, but some medical providers are unaware or bad at recognizing it. I was misdiagnosed as bipolar for years as a result. I question your doctor's expertise if they want to increase the dose in response to insomnia + mood swings! Most likely they have no idea what they are doing. I'd think a lower dose would reduce the insomnia and mood swings. Whatever you decide to do about the drug, I suggest getting a better doctor if you can.

I was prescribed sertraline multiple times and the most memorable time, I would stay up for days, making impulse decisions, spending crazy amounts of money, traveling thousands of miles. I even bought a new car on a whim. It was worse at higher doses, but I still had issues even at 12.5 mg (half of a child's dose.) The doctors I was seeing wanted me to keep taking the drug and then gave me additional prescriptions to try to manage the hypomania. When I stopped I would get incredibly suicidal and nonfunctional. Not all doctors are aware of the potential withdrawals either (euphemistically called SSRI discontinuation syndrome)... I tapered off on my own a few times, but the very last time I tried sertraline, I stopped it by switching over to prozac for a week since it has a longer half life. I have similar effects on similar drugs (other SSRIs and SNRIs) as well.

For BPD - a mood stabilizer like lamotrigine might help, either on its own or in combination with sertraline or another antidepressant. I was first prescribed lamotrigine when they thought I was bipolar, and have been on it for almost a decade now. I am not diagnosed with BPD but I identify with the label enough to follow r/BPD and r/BorderlinePDisorder, and lamotrigine seems well regarded on there.

Damn they are bad at recognizing this? It's comes.in whit the meds, that they might increase suicidal ideation. Psych field really is something

 

[NumbItAll]

I'm no doc but I don't see how increasing the dose will decrease side effects. Having more time to adjust could help. It's all just guesswork since the whole field is a joke. Best of luck.

 

[western_heart]

Damn they are bad at recognizing this? It's comes.in whit the meds, that they might increase suicidal ideation. Psych field really is something

Idk. I'd hope that anyone trained in psychiatry would recognize it, but my expectations are low. My family doctor first prescribed Zoloft and had no idea what was happening when I reported side effects. He referred me to a psychiatric nurse practitioner at that point. She recognized that Zoloft was causing the hypomania, but still diagnosed me as bipolar even though the criteria excludes drug-induced hypomania.
I was then sent to a bipolar specialty clinic and saw maybe 10 different psychiatrists there over the course of a few years. None of them ever asked whether I even have bipolar disorder at all.

 

[chocolatebar]

I question your doctor's expertise if they want to increase the dose in response to insomnia + mood swings!

I thought the same. That and the lack of a mood stabilizer for someone diagnosed with bpd is strange.

i'd recommend seeking another professional for a second opinion on the treatment

Idk. I'd hope that anyone trained in psychiatry would recognize it, but my expectations are low. My family doctor first prescribed Zoloft and had no idea what was happening when I reported side effects. He referred me to a psychiatric nurse practitioner at that point. She recognized that Zoloft was causing the hypomania, but still diagnosed me as bipolar even though the criteria excludes drug-induced hypomania.
I was then sent to a bipolar specialty clinic and saw maybe 10 different psychiatrists there over the course of a few years. None of them ever asked whether I even have bipolar disorder at all.

reading these things is so hard for me. I soffered some similar medical abuse for a few years, enough for me to be skeptical of any doctor

 

[Hollowman]

Their meds are supposed to correct a chemical imbalance. The chemical imbalance theory has never been proven. They don't have a clue what they're doing.

My dumbass had hope in psychiatry for a long time, but after trying 25+ meds I gave up.

My last pdoc asked me what I wanted to do with my meds. Because she obviously didn't know what to do, after trying to 'treat me for years. I said I want to stop taking them.

And she said you don't want to end up back in the hospital do you? All I could think was who's benefiting more from this, definitely not me. I quit pristiq and lamotragine cold turkey without bad withdrawals ( I don't recommend that) and haven't seen her in three years.

If I had to choose ctb or going back to them I choose the former

 

[Regen]

Yeah, it's the first medication I've ever been on. I'm not crazy young, early 20s, the lack of sleep is definitely becoming an issue, I'm thinking of asking for sleeping pills regardless of whether I up my dose this week or not, I'm just so exhausted and I definitely think that's making the depressive episodes and then obviously the suicidal thoughts on top much worse, but I could be wrong.

Gonna have a chat with her on friday, just trying to decide on how I want to proceed before that appt really

I hope your doctor is good enough. And I hope you can tell about the negative thoughts. If you say you had suicidal ideas but not special plans you should be safe. For me it sounds not to good to take this medicine any longer. But maybe the thoughts will get better soon, maybe the doctor know how long this will be... But maybe there is a better alternative for you. Less sleep is very bad for depression and can cause suicidal thoughts too. If you want I would like to hear how was your chat on friday.

 

[MidnightDream]

I thought the same. That and the lack of a mood stabilizer for someone diagnosed with bpd is strange.

i'd recommend seeking another professional for a second opinion on the treatment


reading these things is so hard for me. I soffered some similar medical abuse for a few years, enough for me to be skeptical of any doctor

I thought this too, but they seemed insistent that I try an antidepressant.
I'm not sure GPs can prescribe mood stabilisers or if i'd need to go down the psych route, I'll definitely bring it up tomorrow because I've wondered the same thing for a long time.

I hope your doctor is good enough. And I hope you can tell about the negative thoughts. If you say you had suicidal ideas but not special plans you should be safe. For me it sounds not to good to take this medicine any longer. But maybe the thoughts will get better soon, maybe the doctor know how long this will be... But maybe there is a better alternative for you. Less sleep is very bad for depression and can cause suicidal thoughts too. If you want I would like to hear how was your chat on friday.

I'm not worried, I've told them point blank I have plans and they didn't even seem interested.
I will definitely mention everything and see what she has to say, and I'll update tomorrow :)

 

[chocolatebar]

I thought this too, but they seemed insistent that I try an antidepressant.
I'm not sure GPs can prescribe mood stabilisers or if i'd need to go down the psych route, I'll definitely bring it up tomorrow because I've wondered the same thing for a long time.

I'm not worried, I've told them point blank I have plans and they didn't even seem interested.
I will definitely mention everything and see what she has to say, and I'll update tomorrow :)

what does gp mean?

 

[LaVieEnRose]

what does gp mean?

General practitioner

 

[MidnightDream]

@Regen tagging you because you asked but general update ---

Had the appt this afternoon, told doc everything I told you guys on this thread. She agreed that staying on sertraline (and god forbid doubling the dose) would be a pretty terrible idea, and she wants to try me on citalopram (celexa) instead. Can't pick that up till mon though so got a lovely weekend of withdrawal ahead of me before I can start the new meds.
Still not sure I'm happy being put onto another antidepressant, I don't rlly see how the result will be much different. But I'm hoping by going through all these medications I'll eventually be able to get to something that works. Hopefully.

 

[Hollowman]

@Regen tagging you because you asked but general update ---

Had the appt this afternoon, told doc everything I told you guys on this thread. She agreed that staying on sertraline (and god forbid doubling the dose) would be a pretty terrible idea, and she wants to try me on citalopram (celexa) instead. Can't pick that up till mon though so got a lovely weekend of withdrawal ahead of me before I can start the new meds.
Still not sure I'm happy being put onto another antidepressant, I don't rlly see how the result will be much different. But I'm hoping by going through all these medications I'll eventually be able to get to something that works. Hopefully.

Good luck with that too bad it's not an exact science.

 

[MidnightDream]

Good luck with that too bad it's not an exact science.

No, it absolutely isn't and i'm not sure I'm entirely appreciating the approach of 'try everything until we find something that works, and here's a crisis number incase you try and off yourself in the meantime' but that's the UK health system for you.

Thank you for the luck!

 

[chocolatebar]

General practitioner

Thanks.

I'm not sure GPs can prescribe mood stabilisers or if i'd need to go down the psych route,

In that case, it would be interesting to see a psych. They may better understand your case, especially since there are symptom overlaps and more than one condition diagnosed.

 

[MidnightDream]

In that case, it would be interesting to see a psych. They may better understand your case, especially since there are symptom overlaps and more than one condition diagnosed.

I fully agree, but I don't think I can see one without being referred by the GP which means following their pathway first

 

[Hollowman]

Check out madinamerica.com go to the search function and look up Dr. Peter Breggin. He's a psychiatrist speaking the truth about his field.

 

[chocolatebar]

I fully agree, but I don't think I can see one without being referred by the GP which means following their pathway first

Are you sure you need a referral? Perhaps the medical system where you live is worse than in here.

 

[MidnightDream]

Are you sure you need a referral? Perhaps the medical system where you live is worse than in here.

Yeah, unless I wanna go private but I don't have that kind of money

 

[Ineedtodie]

I tried repiridone, Lexomil, deroxat( they have different lables in different country)
Working so far. Been on them only for a month so far . i tried other meds never were effective for relieving for Anxiety. I find your environment had to with the effects of meds. For instance in already stressful setting, it can be confusing. Lexomil have a very relaxing effect on me. Other factors are involvelved not that I'm aware of or knowledgeable. Wish you patience and best luck.

 

[makethepainstop]

Personally as angry as I am getting I want to try to get my doctor to give me some Xanax, or Valium. I am getting scared of how angry I am getting. I swear just let someone start anything with me., I am ready to go into attack mode. Obviously, I cannot go to work each day angry, but I also can't go to work stoned on THC gummies. Does anyone here know how hard it would be to get valium or Xanax prescribed in the USA? I am getting to the point that when I guy tailgated my going home from at work,(85 mph), I slammed on my brakes. IF the SOB had hit my car you would be hearing about me on your local news. I cannot figure out specifically what is making me just so damn angry.
But I am so damn angry about every little thing. Has anyone else ever felt like this and what did you do?

 

[Hollowman]

Personally as angry as I am getting I want to try to get my doctor to give me some Xanax, or Valium. I am getting scared of how angry I am getting. I swear just let someone start anything with me., I am ready to go into attack mode. Obviously, I cannot go to work each day angry, but I also can't go to work stoned on THC gummies. Does anyone here know how hard it would be to get valium or Xanax prescribed in the USA? I am getting to the point that when I guy tailgated my going home from at work,(85 mph), I slammed on my brakes. IF the SOB had hit my car you would be hearing about me on your local news. I cannot figure out specifically what is making me just so damn angry.
But I am so damn angry about every little thing. Has anyone else ever felt like this and what did you do?

I used to have really bad anger issues, road rage etc. I stopped talking neurotoxic psych drugs and I rarely get mad anymore.

 

[western_heart]

Personally as angry as I am getting I want to try to get my doctor to give me some Xanax, or Valium. I am getting scared of how angry I am getting. I swear just let someone start anything with me., I am ready to go into attack mode. Obviously, I cannot go to work each day angry, but I also can't go to work stoned on THC gummies. Does anyone here know how hard it would be to get valium or Xanax prescribed in the USA? I am getting to the point that when I guy tailgated my going home from at work,(85 mph), I slammed on my brakes. IF the SOB had hit my car you would be hearing about me on your local news. I cannot figure out specifically what is making me just so damn angry.
But I am so damn angry about every little thing. Has anyone else ever felt like this and what did you do?

Hi, I'm sorry you're having a rough time. you might want to start a new thread for this! (ETA: if you do feel free to ping me so I don't miss it.)

In my experience many doctors will prescribe benzodiazepines as a one-time thing, but it'll often be like 15 Xanax or Klonopin with no refills. it's a lot harder to get a prescription for daily use. Idk if they will prescribe it for anger, I usually got the prescriptions for anxiety & with the understanding that the benzo use would be temporary. One time I said I was experiencing insomnia & had been prescribed Xanax before & it helped me sleep, and got a prescription, but ONLY one 30 pill prescription- then a referral to a sleep clinic. I think I got one doctor to prescribe me Xanax twice, but it was a year apart.

Your mileage may vary depending on what kind of clinic you go to, your region, how you present to the doctor, the doctor's mood, etc. good luck!