Wednesday, December 8, 2010

Pharmaceutical NON-COMPLIANCE: The Benefits (+SexyCPR)

Brain structures involved in dealing with stre...Image via WikipediaWay back in 2004, I was prescribed a “selective serotonin reuptake inhibitor” (SSRI) for my depression. It was Sertraline. Commonly known as Zoloft. It did nothing for my depression. It just made me sleepy while driving. So I was taken off of it.

That December, at an annual Christmas Eve party, I suffered a relapse of my PTSD anxiety because… someone died. I was outside enjoying my cocktail by the fire when, suddenly, someone came running out of the house,"Grab her!" he exclaimed, "She used to be a nurse.”

I was then hurriedly ushered into the bedroom of this home where a young woman was lying on the floor. The mother was pacing furiously back and forth across the room, in shock, eyes shut, frantically praying. The girl's sister and a friend had been doing CPR but, apparently too vigorously, as there was a good deal of blood everywhere.

I should have directed the sister to continue mouth-to-mouth while I administered chest compressions. But, in the moment, (and after a couple of drinks) I guess I wasn’t thinking that clearly. I immediately began mouth to mouth… mouth to bloody mouth while the sister continued chest compressions. It was gruesome. We didn’t even do Two-man-CPR. Like I said, I wasn’t thinking clearly.

I suspected she was already dead. My mind kept saying,"Don’t look into her eyes. Don’t look into her eyes." But I had to. Let me tell you, that’s a sight no one should ever have to see. They had already clouded over. It haunted me for days. I couldn’t get it out of my brain. It was just there. And all the blood and more… bits and pieces of a life lost.

I began to have panic attacks again. And parties? That was the end of that. I tried. Seven parties in a row was equivalent to seven waking nightmares. I went into a shell and became almost agoraphobic. It was time to go back into PTSD counseling.

So 2005-2009 was hell on earth and it just seemed to get worse… until I was having “episodes” every single day. The counselor never once mentioned to me, though, that an SSRI might help with my anxiety.

In fact, last December, with the whole Susan Powell thing, my paranoia worsened and my counselor had the audacity to say, “None of my other PTSD patients are fearful every day or afraid of their partners.” I felt affronted. Was she insinuating that I was making it all up? She was young and well-educated but inexperienced. I kept telling her that I was menopausal and that maybe part of all this was hormonal, systemic.

It wasn’t until I had returned from an exhausting family vacation (where I was paranoid and terrified the entire time) that things changed. And it wasn’t my PTSD counselor. It was my gynecologist, who I had mentioned this to, that said, “Oh, maybe we should changed your birth control pills. The estrogen is probably a little too high… and we could give you an SSRI to help with the panic.” What?

By this time I was willing to try anything. Having two or three panic attacks every day was exhausting and my quality of life was just shot. So that afternoon I took a Sertraline and, wow, the rest of that day I was panic-free. And the next day and the next. OMG.

I was furious with my counselor. Why had she not told me about a pharmaceutical “cure”. It could have saved me needless suffering. Years of suffering! And those who have never experienced a panic attack or a PTSD episode do not know mental suffering in just the way we do. It is indescribable mental anguish.

Death is there, staring you square in the face and you must either flee or die. You cannot even rationalize it. That is the definition of the dis-ease. Your body just takes over while your mind becomes one big vibrating blob of fear. And your life? Your life is nothing more, in that moment, than a scene out of nightmare in which you are glaringly awake. Every hair is on end. Every pulse rings loud in your ears and you are the star of your very own horror movie.

So…

I got on the internet and began doing a little research. Yes, Sertraline was used for anxiety. And surprisingly, one of the things I read was that patients occasionally do not have a relapse of symptoms after a few months of treatment. I thought, well that wouldn’t be me.

But then, a few months in, maybe four or five, I forgot to take my daily dose. Nothing happened. I got right back on it. In a couple of weeks I forgot again. This time for two or three days and nothing happened. Had I become one of the lucky few?

I began experimenting. Longer periods, however, did result in more episodes and paranoia. Still, I persisted, telling myself that when the negative symptoms appeared, I would take my meds again. This worked except for the problem of recurring negative side-effects.

Most pharmaceuticals have negative side-effects. With the Sertraline mine were sleeplessness at night, drowsiness during the day, jaw clenching, teeth chattering, and ridiculously dry nose and mouth. So, even though these meds helped with my illness, they were no picnic. This was a good part of my wanting to be off of them.

Now, the doctor had also prescribed Diazepam (Valium). I hadn’t messed with those much. After eight months I still had 10 out of the 15 prescribed. I began taking those instead of the Sertraline, for my now occasional anxiety (because of the negative side-effects of the Sertraline). Now, mind you, if you STAY on the Sertraline, they say that those symptoms recede after a while. But going on and off? That just caused them to recur every time.

So the Valium worked, to my amazement, and without any side-effects at all other than the complete disappearance of my paranoia and anxiety. But when I talked to my doctor the next time she suggested,"Let’s try a different SSRI then” other than the Sertraline. So last week my doctor prescribed a new drug for my anxiety episodes: CITA-LOPRAM HYDRO-BROMIDE.

From Wikipedia, the free encyclopedia:
"Citalopram (trade names: Celexa, Cipramil) is an antidepressant drug of the selective serotonin reuptake inhibitor (SSRI) class. It has FDA approval to treat major depression, and is prescribed off-label for a number of anxiety conditions.
History
Citalopram (pronounced /saɪˈtælɵpræm/)[2] was originally created in 1989[3] by the pharmaceutical company Lundbeck. The patent expired (at first glance I thought it said “The patient expired”) in 2003, allowing other companies to legally produce generic versions.

But, just like the Sertraline, it made me feel really weird the next day - like I was on a drug. I had a strange buzzing in my belly. I had taken it at bedtime for anxiety as prescribed and, unlike with the Zoloft, I slept great. Plus, I had no midday drowsiness or nose and mouth dryness the next day. But... there was more on the downside: Some slight teeth-clenching, although not as intense as with the Sertraline and... I had three panic attacks! So, Citalopram was not for me either.

Oh, yes, I forgot about the loss of appetite (also with the Sertraline). Great for weight reduction but I’d rather eat and enjoy my food (and have to pay with exercise later) than have my appetite completely destroyed artificially. By 5pm that day I’d had only 230 calories. Not healthy.

The first thing to do for your weight and health is quit sugar. See my book The Sugar Addict’s Diet: A Primer for the Low Sugar Lifestyle (New Century Publishing, 2001). Sugar causes all manner of mental as well as physical symptoms and is the main culprit of binge eating.

So I decided to go back to the Diazepam for my occasional episodes. It works great for me in that regard. I’m only taking it as needed which, for me, is about 3-4 times a month. Compare that to the 2-3 times a day episodes before any medication. So I am actually a convert to pharmaceuticals. I used to be entirely opposed, believing that all-natural living could cure anything. Menopause relieved me of that opinion.

Still, there’s a place for self-education and experiment. The doctor reminded me, though, that everyone responds differently. My negative symptoms with the Sertraline were more severe than most and less severe than most with the Valium. She noted that the Diazepam (Valium) was considered highly addictive and that I was one of the lucky few that didn’t seem to have a problem with that.

So…

Last words: Do see a counselor. And you don’t need to avoid medication entirely. It might be the answer you’ve been looking for.

P.S. Okay, so they weren't my last words. I'd really like to end on a lighter note. Everyone should learn CPR.  Here's a video to get you started.







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