I blogged in June about reviewing my anxiety medication, specifically because during the first 4 weeks of coronavirus lockdown I had experienced a significant reduction in anxiety and an insight into how life could be.
I posted recently about my anxiety medication and my intention to ask the doctor to review it.
Today I telephoned the Doctors surgery to ask to for a non urgent appointment to discuss my medication. I was advised that, because of Covid-19, the GP was not reviewing medication at present. So having felt somewhat deflated, after plucking up the courage to telephone, I thought I would try writing to them instead.
I am struggling with my anxiety as usual. During the first 3- 4 weeks on lock down for coronavirus, my wife and I screened ourselves. I found that not being allowed to go out and not having any appointments to go to, resulted in my anxiety easing significantly and I was happy pottering around at home and working part time at home on my computer. Now some 12 weeks later I find my generalised anxiety back to where it was prior to lock-down and having seen how I can be during those first three weeks, I want to be more like that.
It has been sometime since my last blog post. I still struggle with and have been working on my anxiety and depression.
As usual time has passed – back in July I went and visited my GP for the first time in a long time. Since then I have been back to see him a couple of times. After my first appointment, we agreed that I would try out an additional medication, so I started on Sertraline at 50mg once a day for two weeks, then increased it to 100mg once a day. I have been on this dose now for 3 months. Here is a useful explanation of the medication Sertraline on Mind’s website.
I have decided to go to see my GP about my anxiety and depression, so thought it best I pull together a history of medication I have been prescribed over the past 9 years. Here is the medication I have been prescribed for anxiety and a link to a description on the Mind website:
My poor wife has to take various medication at three different times in the day. It soon became impractical and confusing to just take the tablets direct from the packet and meant there was often a conversation about whether medication had or hadn’t been taken. So we have bought a few different tablet boxes, also known as a dosette box or medication dispenser over the years.
Occasionally I miss a dose of Pregabalin, my mental health medication for my anxiety. I take 300mg of Pregabalin (Lyrica) twice a day and have been for about 18 months now. Saturday night I fell asleep early and forget to take my medication. Sunday I felt, well all I can really come up with is odd. I was more touchy and short tempered – sorry family. But what I really noticed was that I was so itchy.
As part of Crohn’s and Colitis Awareness Week (1st - 7th December 2016) the charity Crohn’s and Colitis UK are offering a poster creation app, that lets you build your own poster about how Crohn's or Colitis impacts you. So here is my poster about how Ulcerative Colitis impacts me and what helps me through.
I am lucky, that I do not have too many flare ups, but when I do, I feel incredibly tired, bloated, get bloody loose stools and have to use Pentasa Enema's 2 or 3 times a day on top of taking Pentasa tablets twice a day. For me a flare up last for a few weeks, but I become very house bound and have trouble finding the best food to eat and I hate using the Enema's, but they do help and directly work on the inflammation. As I have said in my poster the care, support and understanding of my wife makes it all a lot easier.
Hopefully this awareness week and the social media campaign of #CrohnsColitisAndMe will help raise the awareness of this invisible disability.
I have been told about a really useful new App that has been available in Germany for some time and is now here in the UK
The App is called MyTherapy and is available to download for free to help manage medication and treatment, by reminding you to take medication and recording activity and other health information.
I searched for MyTherapy in the Apple App store and downloaded it easily and quickly. You have the option to register with your email address or just provide your date of birth and sex. I then used the barcode scan feature for my Pentasa tablets and entered the details manually for my Lyrica 300mg tablets.
I have managed to make an appointment with my GP for this afternoon and it is the doctor that we usually see for my wife, so she has a good idea of what Is going on.
I think it is time to review my medication, so I have been going through my old MyAnxiety blog posts to see what I have been prescribed over the past 5 years. From what I can piece together I started on Citalopram, followed by Seroquel, then Duloxtine, being increased to 90mg a day, then Pregablin and Trazadone. But I found the side effects of Trazodone difficult, so ended up on 150mg Pregabalin twice a day. Which must have been for the past 2 years now. From my posts I read that I found the Trazadone good for my mind but not my body (aches) so came off it. Interestingly enough I would now say I would rather risk the aches to see how I get on with the medication as I seemed to find it helpful for my mental health.
So, what am I going to say, that I am finding things very difficult, increasing periods of not being able to do anything, was a struggle maybe 1 or 2 days a week, now majority of week, I am short tempered, snappy, don’t want to see or talk to anyone, upsetting family when I do, panic attacks back, sick of not being able to go anywhere without getting anxious, bowels triggered etc, exhausted after doing one thing/trip out, retreating to my bedroom all the time, increased and more difficult to manage suicidal and self-harm thoughts . I am very angry, frustrated and difficult to be with. This has been building up for the last 4 to 6 months.
I am taking 150mg of Pregabalin twice a day and attending Person Centred Therapy counselling with Rushden Mind once a week.
I am reluctant to get referred back to Mental Health Team, so hopefully the GP can suggest a medication change for me.
Wow, it has been a month and quite a bit has happened.
A month ago, I blogged that I recognised I was stuck in a cycle with anxiety feeding IBS feeding anxiety, which was at the least hindering my recovery. So I have had a string of appointments over the past month, which included, GP, Psychiatrist, Gastroenterologist, and an Endoscopy.
So, to start, an anxious visit to the GP: who as usual seemed to lack empathy. I explained my bowel symptoms and link to anxiety. He concluded that I displayed the symptoms of Irritable Bowel Syndrome and suggested I discuss it more at my next Gastroenterologist appointment.
Thankfully my appointment with the Gastroenterologist was the following week. He agreed that it sounded like IBS and said having looked at my blood test results that my IBD was under control. He suggested I have an Endoscopy to check my bowel as I had not had one for ten years. In terms of the IBS he suggested a drug called Amitriptyline, but because of my other medication wanted the Psychiatrist to prescribe it.
I then had my appointment with the Psychiatrist, where I discovered that the Gables Mental Health Hospital site has been closed and that I had another new doctor. We explored my medication and I was reluctant to change the Trazodone, as it has been good for me. So the Amitriptyline was not an option if I was to stay on Trazodone. He did though increase my dose of Trazodone to 150mg a day.
My outpatients appointment for the Endoscopy was fine. The consultants letter to my GP said there was no signs of inflammation or history of inflammation and that I no longer needed to take Asacol.
So the outcome of these medical appointments seems to be a diagnosis of Irritable Bowel Syndrome (IBS), but I do not have IBD. So this means I can now focus on my Anxiety and IBS.
17th July 2013
PDF File Version for Blog Post- Visits to GP, Psychiatrist and Gastroenterologist, for printing or saving
Sorry everyone - bowel talk! So I have now worked out that my bowel control problems are not necessarily a symptom of my Ulcerative Colitis, (Inflammatory Bowel Disease) and have now been diagnosed with Irritable Bowel Syndrome (IBS).
So how did I get there?
Well I recognised that I had got caught up in a vicious cycle of getting anxious about bowel control, which meant my bowels reacted, which means my anxiety is proved right and round and round it goes, meaning I stay in the safety of my home. Bowel accidents do happen and have happened for many years, thereby confirming to my brain that it is right to be anxious.
So of to the GP I went and explained my thoughts, he said discuss it with my Gastroenterologist, with whom I had an appointment coming up soon.
So at my appointment with the gastroenterologist I explained again. He confirmed I probably had IBS linked to getting stressed and anxious. He suggested Amitriptyline, for stopping signals from my brain to bowel, but said that I would need to discuss it with my Psychiatrist, because he did not know how it would react with my other medication.
Luckily (again) I had an appointment with my Psychiatrist fairly soon. So we discussed it all, for me again. He concluded that Amitriptyline could not be combined with Trazodone. As Trazodone has been my best medication to date, I did not want to change it. So we concluded we would have to leave Amitriptyline medication for stopping signals from my brain to bowel for the time being!
It took me a week to recover from the anxiety of these trips and successfully entrenching my brains control of my anxiety and bowels. But I will not give up!
See my separate posts on my current medication [LINK TO FOLLOW] and trip to Psychiatrist [LINK TO FOLLOW]
22nd June 2013
I have been taking 150mg of Trazodone at night for a week now, the good news is my head / mental health seems to be a lot better, I feel less anxious and depressed.
BUT I am suffering with aching joints, particularly my knees and back, find it difficult to physically get out of bed because I ache and feel so 'heavy', to the point I am close to calling my wife to help me out of bed.
I have found a number of discussions and acknowledgments of the problem of joint ache whilst taking Trazodone, but no one seems to be talking about what they or the doctor did about it. I would be reluctant to stop taking Trazodone because I feel so much better mentally. Anyone else got any experience of how they dealt with the pain?
14th January 2013
The medication I take of Trazodone, Pregabalin and Asacol Mesalazine tablets are working for me so I will continue with them
I am attending Solution Focused Brief Therapy every two weeks and find that very helpful; I always come away feeling more positive, happy and motivated.
I am spending a lot of time developing My Anxiety website, which is giving me focus and purpose. I am now considering establishing it as a charity so watch this space
I have had my bicycle repaired and want to start using it more. Physical activity helps both Ulcerative Colitis and depression and anxiety.
I am getting things done in our home, many things have been left like fitting the skirting board to the lounge and dining area and repairing the shower. I am not doing it myself I hasten to add, but have had builders into quote and one of them starts next week on the skirting board.
2013 has started well, I feel I have a purpose and a plan, which accommodates my mental health as it is, so I don’t have to think if only…. All of this is helped by knowing I have not got to prove that I am ill by attending a DWP ESA Medical until March 2014. I feel that they are leaving me alone for a bit.
11th January 2013
I have been on Trazodone 150mg for a week now.
Firstly Trazodone has stopped the awful side effects I was getting from Duloxetine withdrawal – which is great because the nightmares, dizziness, brain zaps and sleep problems where getting to much. So lesson learnt is always do what the doctor tells you...............
Secondly the Trazodone seems to be alleviating my anxiety and depressive moods. I sleep 8 hours a night and have no recollection of any nightmares in the morning.
Thirdly, whilst my head is better the physical effect on my body is significant, getting up is hard work and my whole body aches and is difficult to get started. During the day my joints ache and are slightly ceased, I suspect I am walking like an older man and have to be careful on the stairs. Hopefully this will pass once my body is used to the Trazodone
Trazodone is an older drug and part of the serotonin antagonist and reuptake inhibitor (SARI) group. I assume from the fact it stopped my withdrawal from Duloxetine that it is managing my serotonin levels, but in a slightly different way
So other than the fact my body aches and getting out of bed is so hard, the Trazodone is working. Given the choice between how my head was mentally before and the current physical difficulties, I would opt for taking the Trazodone any day.
Another benefit to me is I have a sense of purpose again, hence all the activity on My Anxiety website and establishing all the social media accounts
11th January 2013
I don’t know whether I am making a big mistake but I am trying to come off Duloxetine (Cymbalta). I have not taken Duloxetine for 5 days now, having slowly reduced my dosage over three weeks.............
Following a recent visit to the GP, I think I have a slightly better understanding of how care operates in the NHS, UK........
Medication for Anxiety & Depression seems to fall into 2 groups:
My Medication for anxiety and depression is considered below, click on the image for more information from NHS UK about the drug ........
Citalopram was initially prescribed and my dose was slowly increased to 40 mg per day. My health got worse, whether this was eased or exacerbated by the Citalopram is unknown, this prescription was changed after 18 months. I found it had no side effects on me.
Seroquel (Quetiapine) as prescribed for about 6 months, I did not get on with the drug as I was knocked out most of the time, so it was changed.
I have been taking Pregabalin (Lyrica) for 18 months, between 200 and 300 mg twice a day, initially this drug made me light headed and dizzy but now I am comfortable with it. I still take this medication
My Duloxetine (Cymbalta) pescripition has been 60 or 90mg. I currently take 90mg once day. I am currently on 90mg with 200 mg of Pregabalin. I have found no noticeable side effects
I have also had a prescription for 5mg tablets of Diazepam which i take when i am struggling greatly with anxiety. I find Diazepam acts as a sedative for me.
The general principle of treatment seems to be that medication will help you on the road to recovery whilst therapy and/or time will actually enable the recovery; well this is the case for anxiety and depression so they say. I am told to use the analogy of a broken leg, the medication is the plaster cast and pain killers and the time and physiotherapy exercise after the removal of the cast is the therapy. My only observation is that three and a half years is a blasted long time to mend a broken leg!
Below I consider the therapy and medication treatment I have accessed .......
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