Psychological Reactions to Medications Part 2

[Kizzie]

OMG San, I hate that you had a psych who didn't believe you.      That's a huge problem when it comes to having any mental health issue - suddenly what you have to say is suspect. Argh.  So sorry you went through that.  More of us need to tell our stories of being dismissed, invalidated, not having our wishes taken into account, not being given enough/proper info.  There's a sense of elitism in medicine that even my son has picked up in 2nd yr - can't write about it right now because it's too painful, but we (patients) have to do much more pushing back, questioning, making our opinions/needs/wants known, etc.,  all to remind medical professionals we are thinking feeling human beings worthy of respect.

My GP hasn't received the report from the psych yet so is going to phone to get it expedited.  In the meantime she completed my physical yesterday for the Ketamine and sent everything over to the clinic.  The clinic head is off until Tues so will review everything then to see if I'm eligible.  His assistant didn't think there would be problem though. 

My GP isn't sure about Risperidone and Ketamine either.  She does know I am very keen to try the Ketamine so I wouldn't be surprised if we do the Ketamine treatments before looking at Risperidone.  It could be that I may not even need a psych med like Risperidone that ongoing Ketamine assisted psychotherapy will be enough for me.  Now that would be awesome as I'd rather not take any more psychiatric meds period. The psych may push it but he's not my psych per se, more of an advisor to my GP and I and it is my choice afterall. 

[Armee]

Oh God my heart just dropped a few feet reading Risperdone on here. I've never heard of that for anxiety, depression, or PTSD? My mom was on it. I've only heard of it being used for psychosis for bipolar and schizophrenia? I think the side effects are enormous?  I can't imagine you feeling better on it...

And I'll just add sometimes my PTSD does present as hallucinations...hallucinations that seem to be flashbacks...especially smells and images. These are very different from psychotic hallucinations where you think things are real and you can't walk down the street without screaming at them.

[sanmagic7]

i agree w/ everything you've said about the medical profession, kizzie.  i was given risperdone when the shrink thought my bipolar (my diagnosis at the time) was worsening on my reg. meds.  i was in mexico at the time and too sick to put up a decent argument in spanish.  i am on meds now, but for anxiety and to help me sleep (xanax and trazadone) and they're working just fine for what they've been prescribed.  trazadone is an old school anti-depressant w/ sedative effects and i'm on a small dose.  but i had to fight for it cuz the other meds which were first prescribed for me did not work at all.  sometimes it's a crapshoot.

i'm so glad you have a GP who is working WITH you on all this. i also agree w/ armee that there is often an elitist attitude around docs and shrinks.  they may have all the book learning and can quote references by the 100's, but they don't care too much about the individual unless the symptoms are within the bell curve.  the bell curve covers about 80% of clients, but that leaves 10% on either side who don't fit w/in the parameters.  unfortunately, that 20% is too often ignored or dismissed.

reminds me again of the story of the black swans.  no one believed in them back in the day, believed all swans were white, and dismissed stories about them w/o looking at the possibility of their existence.  one day an explorer discovered them in australia and brought 2 back to his homeland for proof.  now a 'black swan' is a term for something unpredicted or unpredictable.  i believe we are black swans, in that we may be unlike what others want to believe about us, but we are so very beautiful just the way we are. 

good luck w/ your continuing journey, kizzie.  i sure do hope you find relief.  love and a hug filled w/ stand your ground.

[Kizzie]

We (those who don't respond to meds in the predicted way) are the black swans, I love it San.  I did not know that story by the way. 

I may have posted this study already but recently a GIANT black swan was revealed in medicine about the assumed link between serotonin and depression The serotonin theory of depression: a systematic umbrella review of the evidence

Our comprehensive review of the major strands of research on serotonin shows there is no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations or activity.

The chemical imbalance theory of depression is still put forward by professionals, and the serotonin theory, in particular, has formed the basis of a considerable research effort over the last few decades. The general public widely believes that depression has been convincingly demonstrated to be the result of serotonin or other chemical abnormalities, and this belief shapes how people understand their moods, leading to a pessimistic outlook on the outcome of depression and negative expectancies about the possibility of self-regulation of mood. The idea that depression is the result of a chemical imbalance also influences decisions about whether to take or continue antidepressant medication and may discourage people from discontinuing treatment, potentially leading to lifelong dependence on these drugs .

This is not to say that SSRIs have not helped many, they have but not in ways they were thought to and for reasons not fully known. 

The impact of this study is huge; as the authors suggest, doctors and patients are making life altering decisions based on flawed assumptions about anti-depressants. Yikes.

[sanmagic7]

yikes, indeed, kizzie.  as part of the 'helping' scene, i've been taught and have believed for years the chemical imbalance theory.  it's amazing to me, once again, how much we didn't know what we didn't know.  thanks for this.  love and hugs

[Blueberry]

I second the 'yikes indeed'.

[Kizzie]

Armee what I've read about risperidone so far is that it is another one of those meds that is used "off label'  for issues it has not been approved for by the FDA. The psych who assessed me said it would be a very small dose 5 or .5 mgs (?), but I have to wait until my GP gets his report as I couldn't hear him very well and I didn't know what to ask about it.  He did see the look on my face though and said not to worry because it was going to be such a small dose.   

Personally I am going to be asking the question "Can I do without it period?" especially if the Ketamine seems to help me.  After everything I've been through since Jan I'm pretty much done with psychiatric meds and looking to try psychedelics paired with therapy.   

[sanmagic7]

good question, kizzie - i hope you get an answer that is healthy and safe for you.  backing you up on this.  love and hugs

[Kizzie]

Tks San, back at you   

I should know more this week, maybe even tomorrow and I will be sure and pass along whatever I learn/experience with all this meds biz.  We need more info on the subject, that much is clear to me. 

[Kizzie]

So a lot has happened since I posted last.  It has ended up that I am going with a more expensive clinic for the Ketamine treatment because with the one I started intake with I would have had to wait until at least the week of Oct 10th. Truth be told I can't do this anxiety and depression anymore. I did all the assessments for this other clinic (and there were a lot!), and will start Ketamine therapy next Fri (Sep 23).  I have a team rather than a single therapist and it includes psychiatrists, psychologists, nurse practitioners and a few other specialists I haven't heard of before. They work with a lot of trauma survivors huzzah! They do a weekly case review  of each client as a team so there's  a lot of expertise guiding treatment. Expensive as I said but honestly my husband and I just want me to be well again so we went for it. 

I am excited but also a bit of a crying wreck because not only am I tapering off the SSRI I'm on, but also the meds I was taking to help with the anxiety (a benzo and sleeping pill). Apparently they block the effects of the ketamine.  It's only a week and I don't have to be right off them by next Friday, but I will start to feel anxious again because now I'm having withdrawal along with the anxiety still caused by the SSRI.  It's just been a really nine long months and I don't want to go through any more anxiety period.  I'm also scared the Ketamine won't work for me.

So one take away from my experience is that apparently to get the most out of the Ketamine you need to be off or reducing certain medications.  It helps to know this in advance, I didn't and it threw me big time.  I thought I could take the meds I was using to keep the anxiety at bay right up until I started Ketamine and then taper off and it would be fairly easy because I would be feeling better and wouldn't need them. So much for that idea! 

As hard as this is if you do choose to try Ketamine therapy and the clinic doesn't require this you may want to find one that does so you get the most out of the treatment. Ketamine is a money maker and it's likely not all clinics are doing the best by their clients.

[sanmagic7]

good advice, kizzie.

i am so glad you're having a team effort to surround you as you begin this leg of your journey.  fingers crossed and prayers flying that you get some relief from what you've been experiencing for way too long.  that withdrawal stuff is so horrible.  standing with you as you enter this phase, and hoping heartily that the ketamine works for you.  sending love and a hug to embrace you and this new endeavor,

[Papa Coco]

Hi Kizzie

Hugs, hugs, hugs.   

I was about to check in with you.

I'm glad you were able to move your Ketamine infusion forward with a new clinic, and I'm glad to hear that you are going to be surrounded by more clinicians with Trauma experience.

While I waited for my first infusion, I was so depressed I was seriously concerned for my life. I too was very terrified that the Ketamine wouldn't work. It was my biggest fear going in.  The fact that it helped immediately, was my greatest relief coming out.

As for this next week as you're coming off all the medications, I am sending as much love as I can through the ether. Prayers. Meditations. Healing energy. Whatever we all call it. In spirit I'll be contributing as much healing energy as I can to you every day.

A lot of people care about you, even those of us who haven't met you face to face. Feel us with you.

[Armee]

That must have been a huge shock to suddenly have to taper quickly. I feel really relieved for you though that it is happening soon and that you have a good strong team of specialists supporting you. Big strong hugs holding you up until the 23rd and then some, OK? We're holding you here.

[Kizzie]

Tk you so much San,  Papa  and Armee,     I so need more support in my life than I have allowed up until now and I hope the Ketamine therapy will help me be more open to that.  I'm good at giving support, not so good at asking for it.

I think of you a lot these days Papa and hang onto how you felt going to your first infusion and then how quickly you felt better. I hope the same holds true for me and that at some point soon we will both have access to psilocybin therapy.  It would be the icing on the therapy cake 

The psychiatrist who did my assessment this week (very long and thorough - was exhausted afterward), said something to the effect that she thinks the treatment will pop me out of the trauma track I'm stuck on.  At this point you can shoot me out of a canon if that's what it takes.

[Kizzie]

So sadly the first session of Ketamine treatment went quite badly as I've written elsewhere (I think I have, in a bit of a muddle still).  I was extremely anxious when I went, the dose they gave me was too high (and the lead psychiatrist admitted this to me), and the protective part of me stopped everything about 3/4's of the way in and said "No more, this is too much." 

I really crashed in the days after that but was able to talk with both my GP and the lead psychiatrist and I am going to try again at a much lower dose and once I can get my anxiety to settle a bit. Instead of putting me on an antipsychotic Risperidone like the psych who assessed me at the end of Aug suggested (and which could take weeks to work), the clinic psych put me on 500 mg of Gabapentin 3 times daily with my GPs blessing. Apparently Gabapentin can calm anxiety fairly quickly - we'll see.  The clinic psych strongly believes that Ketamine is one of best/strongest antidepressants available but we just need to lower my anxiety which has gone over the top and approach me in a softer/gentler manner or my fear responses will kick in again.   

On a really positive note, yesterday I finished tapering off the SSRI I was on.  Done with SSRIs after 30 years on them, wahoo!!