About Libby Bonner Expertise I am a member of the National Alliance for the Mentally Ill. I can suggest publications, websites, and support groups, answer basic financial questions, answer general questions about meds. I can answer both practical and clinical questions. My 40 year-old daughter has bipolar illness, primarily depressive, and anxiety. She was diagnosed at age 21. I also have a library master`s degree and worked for many years as a clinical/hospital librarian answering reference questions from professionals and the public. My expertise concerns the serious mental illnesses: bipolar disorder; depression; and schizophrenia. I also know about what kinds of care to expect from different professionals/providers. I am not qualified to help families with patients under 18 I cannot answer questions about herbal remedies.
Experience Familiarity with the healthcare system. Working at a large hospital with a pscyh in-patient unit and an affiliated mental health center. Having a daughter with a chronic mental illness. Knowing many consumers, many diagnoses, when they were doing well and not-so-well. Taking, and now monitoring, the NAMI Family to Family class. Facilitating NAMI caring and sharing support group for family members.
I was diagnosed with major depression in '96 and have taken Zoloft since that time at gradually increasing doses. Having taken the maximum therapeutic dose (200mg) for over a year, I'm "pooped out" with not infrequent suicidal thoughts.
[Note on doctors: I'm uninsured. Cannot get primary care/gynecologist to address. Just spent months trying to find a psychiatrist only to spend $150 to be told I need therapy, not a new drug.]
Initially, I'd like to find another antidepressant to take in combination with Zoloft to avoid the long and scary process of discontinuing Zoloft. I know Zoloft may NOT be combined with an MAOI, but what about a trycyclic like Effexor starting with an appropriately low dose?
Alternatively, I'm considering Levothyroxine at a dose appropriate for subclinical hypothyroidism (25mg initially, possibly increasing to 50mg).
Finally, would it make any sense to try celexa? If so, would I have to go cold turkey on Zoloft first?
Many thanks for your time and thoughts!
Answer Terribly sorry, but I am not a doc so am not intimately familiar w/ details of specific anti-depressants. Also, tho I am sometimes bold in my suggestions and recommendations, I would never, never think of advising someone how/when/whether to taper off [or stop] a drug and/or begin a new drug.
Since you are uninsured, a natural question is: who pays for meds and/or how obtained...and you seem to have good access.....and some confidence about taking charge of this. [A good thing, not a bad one, but "only a fool has herself for her doctor."]
I am wondering what your psychiatrist diagnosed, if anything. Was he recommdending cognitive behavioral therapy - which see, online, or its successor, whose name escapes me..... Also check online for self-help books. I do know that NAMI www.nami.org for many years recommended The Depression Workbook. --- Can you scare up a bit more cash either for a 2d psychiatric opinion or for psychological testing? -- And what did doc say about suicidal ideation????
For more info on meds, see www.rxlist.com You may also find good algorithms for drug treatment [the order in which a drug and/or drug-combo might most logically be deployed for a given condition] at www.mentalhealth.com Probably several will be under the "External Resources" section.
Try also www.dbspa.org I do think they have online chat w/ other patients.
Any suggestion from doc re OCD? Is it possible to be not depressed yet be obsessing about suicide...? Do you have a means in mind and have you ever attempted suicide?
Do you have lab tests re your thyroid situation, or is this just empirical?? If the latter, you do need baseline labs and some regular testing once on meds. Also, FYI, liothyronine, Cytomel, is a T3 agent that also has antidepressant effects. If has significant side-effects, however, and cannot do what Synthroid [T4] can, which is convert some T4 to T3.
A last thought re tapering......it would just seem unwise to me to go cold turkey off any med if one were at a max dose....but what do I know? About tapering, not much.
Good luck. Write w/ more info if we need to talk things over.
