There’s a lot of stigma around taking psych meds to treat mental illness. Meds certainly aren’t right for every person or every condition, but they’re a good tool to have available as part of the mental illness toolbox. For all the social kerfuffle over meds, they are just a tool. Getting well (or getting by) with the help of meds is no less valid than getting well/getting by with any other tool from the toolbox, even if it sometimes feels a lot more complicated than that.
We don’t often talk about what we take, so in this post, I wanted to get personal about what I take, and hopefully, some of you will join and share.
My meds
Here’s what I take for my illness, which is major depressive disorder:
- Venlafaxine (Effexor) 300mg daily
- Mirtazapine (Remeron) 30mg daily
- Lithium 1200mg daily
- Quetiapine (Seroquel) 600mg daily
- Dextroamphetamine (Dexedrine) 30mg daily
- right now I’m taking a straight omega-3 fatty acid supplement, but usually I take one combined with turmeric
The first two are antidepressants. The other three are used for augmentation, and an augmented antidepressant regimen can start to look more like what someone would take for bipolar. Lithium is used primarily in bipolar disorder, but it’s also been recognized for a long time as being helpful for antidepressant augmentation. Quetiapine is an antipsychotic. I actually tend to feel better at a high dose, but I like having room to go up if necessary, so I stick with 600mg as a regular dose. Dextroamphetamine is a stimulant that I take mostly because of the link between psychomotor retardation and dopamine.
My dosette
I got this medication dosette after I accidentally took my bedtime meds in the morning, and had to cancel a massage appointment because I couldn’t stay conscious. When I got it, I felt like it was lined up wrong, and the morning should go at the bottom. If that was my automatic response, I knew that’s what I’d do if I wasn’t paying attention, so each day’s container is flipped upside down.
Tuesday at noon shows a dose of Dexedrine that I forgot to take. I tend to miss my noon dose about once a week, and I don’t get an immediate effect from taking it, so I don’t notice the absence of that. Morning meds I rarely forget, and I can’t sleep if I forget my bedtime meds.
Side effects
I don’t have much in terms of side effects. I’ve gained a lot of weight while on meds, and three of the ones I’m on are probably contributing to that, but I’m well beyond caring. In the past, I’ve had dry mouth, tremor, and impaired coordination from lithium, but they haven’t been an issue for a while now. That could very well be an indicator that my blood level is on the low side; I haven’t had it checked since pre-COVID times.
There’s no doubt in my mind that I’ll be on meds for the rest of my life. I don’t view taking psych meds as being any different from taking any other kind of meds, and getting off meds for the sake of being off them isn’t something that has any importance or value to me. It doesn’t bother me that I’m taking 5 different meds; if 1 med worked, I’d take 1, but it doesn’t, so it is what it is. I also don’t care that I take 15 pills/capsules a day; I got used to swallowing meds a long time ago, and knocking back a handful at a time isn’t a problem.
So, that’s what I take. If you care to share, what do you take?
For more info and MH@H posts on psychiatric medications, visit the Psych Meds Made Simple page. There’s also a Psych Meds 101 series covering:
Ashley L. Peterson
BScPharm BSN MPN
Ashley is a former mental health nurse and pharmacist and the author of four books.
I recently started to get help for MDD and anxiety. I am currently taking 50mg sertraline (zoloft) and 150mg bupropion (Wellbutrin XL). It helped a lot at the beginning but I feel it all coming back. It’s really hard for me to talk to my psychiatrist just because I have a hard time talking about how I feel in general. I still get panic attacks and occasional intrusive thoughts. I’m doing my best and I know I’ve gotten better, but I don’t know. Sometimes I feel like nothing has changed.
That sounds really tough. Those are starting doses on both of those meds, so there’s lots of room to go up if needed. I’ve been on 200mg sertraline and 300mg bupropion in the past. Relatively better is good, but you deserve more than that.
Contramyl XR; Setraline: Quetiapine…
I’m not as advanced on this as most of you. I have been correctly diagnosed with severe adult ADHD, but three successive medications exacerbated my sleep paralysis, which is an intermittent condition I’ve been dealing with since I was fourteen years old.
ADHD is inconvenient. Sleep paralysis is terrifying. So I don’t know what to do other than pursue more natural means of processing my thoughts to avoid the enormity of the deficit.
For the record, it seems that the experience of the deficit in waking hours is very similar to the experience of the paralysis in sleeping hours. So maybe there’s a certain fixed amount of “deficit/paralysis” that has to always find a place in my system, and if it’s booted out of my consciousness, it appears in sleep states.
(Of course, if that’s not pseudoscience, I’m not sure what is.)
That’s so frustrating that none of the meds are even remotely tolerable.
I do know of some drugs that effectively bi-pass the paralysis and enable me to go straight from a waking state to a sleep state without the interference of a half-sleep state. Benzodiazepines are particularly effective in this regard. I’m just wondering if I want to get onto a combined Adderol-in-the-morning Adivan-in-the-evening regimen (like some people I’ve known). Shades of Sigmund Freud.
I had a boss with severe ADHD once. She would enter the building in the middle of a sentence amped up on Adderol, and if you wanted her to hear a word you were saying, you had to catch her by telephone between 9 and 10 at night when she was “coming on” to her Klonopin.
(I think that particular boss had a problem other than mere ADHD however — just a difficult personality to begin with.)
Either one alone can be a pain in the ass, but that combo would be like pulling teeth trying to get anyone to order/reorder it!
I think they’re both pretty tightly controlled – at least in the States.
In many other countries too, adhd stimulants are abused and benzos too, so psychiatrists are really reluctant to prescribe. Some particular combinations with other things make the effects stronger as well.
It takes me a couple of years to go through 20 Ativan, so that’s not too much of an issue for me, but everyone gets their knickers in a knot about the dextroamphetamine, which I take regularly.
Danggg
I started with Wellbutrin but it made me feel like a caffeinated squirrel on speed so we switched to 100mg of Pristiq. I seem to tolerate it well and it is off-label for pain which seems to help with my lupus. I think we will be upping the dose soon though because it doesn’t seem to be quite enough for my depression. I also take Seroquel at bedtime and am taking 200 mg at the moment but we will be upping that one as well. On top of those two I take abilify and klonopin. Plus I take 4 other meds for my lupus. I have the exact same medicine case as you and when I first bought it I cried because I never in my life thought I’d be taking that many different meds, but here we are and it is what it is. :/
Somehow, the idea of multiple meds is fine for me, but switching from using the bottles to the med case was like ok, I am officially a patient now.
I always used a med case (there’s only simple 1 week ones here) because I’m forgetful as hell. And I can’t find any big enough ones that’ll hold the bigger vitamins (eg calcium and omega 3).
Pill cases definitely aren’ made with people who take vitamins/supplements in mind.
Good to know haha! I forget my vitamins/supplements so often. I did find a bigger med case eventually so I use that for my omega 3 and vitamin b. The smaller one for my psych meds
Nice!
Great post and I learned some new things about lithium as I thought it was exclusive to bipolar. Those pill sorters are a godsend and I take pride in being g a 28yo grandpa when I sort my pills each week.
I’m on Prozac, wellbutrin, clonazepam (prn), and trazodone. Also vitamin d supplements with a multivitamin. Took a while to get a medley that works but I’m happy with it currently.
Loved this post idea for breaking stigma.
Thanks! Yeah, it can take a while to find the right combo, but definitely a good thing when you finally find something that works!
I’m currently on 1,500mg of Depakote, 35mg of Mirtazapine and 5mg of Ramipril. I’m seeing the Psychiatrist on Monday as I have what looks like the early onset of Psychosis. It looks like I will be prescribed Quetiapine as a result. For the last 2 weeks I’ve been on 1mg of Lorazepam to keep me calm
I hope the quetiapine helps if that’s what ends up happening.
It seems like the logical option but the Psychiatrist will obviously be able to advise me on Monday. I’m determined this time to ask for an explanation for what is prescribed and what is the next step. I did plan to do it before but I didn’t get a word out
You certainly deserve an explanation.
I have researched with the books I have and my conclusions are based on this. I have an antidepressant, which is Mirtazapine, and it is beneficial for me. Sertraline wasn’t so as they basically have opposite moods of action, the issue I have is maybe due to serotonin? Then I’m on a mood stabiliser to do exactly that. This leaves the issue of going hyper and the psychosis issue. Quetiapine seems tailor made for this
Sounds good.
At the moment, I take three meds at (from what I understand) relatively low doses: Depakote for mood stabilization, Paxil for anti-anxiety/depression, and Risperdal (anti-psychotic).
While I don’t like taking psych meds, it’s something I’ve come to accept. And, like you, I don’t feel it necessary to get off them just for the sake of it. I do find it weird though that most psychiatrists never talk much about getting off them. For me, there’s always been a tacit understanding that you stay on them indefinitely.
My father was an addict and I learned later on in his life that he abused many prescription drugs, especially Oxy and Xanax. This is one of the reasons I don’t feel weird about taking meds – I take them as prescribed.
I think from psychiatrists about getting off meds depends, at least to some extent, on the diagnosis. With an anxiety disorder, meds might get someone well enough so that they can do the exposure work that could keep the illness under control without meds, but with mood and psychotic disorders there’s always going to be a high risk of relapse without maintenance treatment. Who knows, maybe someday science will be able to pinpoint exactly what’s gone wrong so that it can be resolved at the source, but until then, I’ll keep popping pills.
Hi there Ashley,
I enjoy your posts specially this one. I’m a brand new NP in mental health. I’m in awe of all the different cocktails of psychotropic meds that providers rx for people. This post was such a learning experience for me. I’m grateful people like exist whos making a difference in healing mental disorders. I have two of your books. They’re wonderful. One about meds I read cover to cover. Thanks for all your contributions to mental health and wellness. You are a true gem.
Thank you!
Yes I found that even my low does if stimulant messed up my sleep. I could fall asleep at a normal time (if taken early enough) but for no good reason would wake up after only 5hrs. I figured it wasn’t worth it and now will use caffeine (coffee), gym, vitamins to help. It doesn’t do nearly what the meds did but my sleep is back on track and I don’t crash hard after 7hrs at work. I heard the waking up early could be my body craving the med and the start of withdrawal. So the earlier I wake up the sooner I might get my body the fix with the med. Similar to why people drink coffee as soon as they wake up to stop withdrawal. Keep in mind I was on a low dose only a few months in and super strict on when I could take it. However my body was still craving it I swear. I’m careful with my coffee consumption also and will purposely use decaf some days to avoid strong addiction. (I don’t have an addictive personality…..but still better safe than sorry.)
I’m glad this is helping you. As a kid I was put in a bunch of meds that also caused weight gain and made me feel just okay. I never was really happy and never was really sad. I was just fine.
I was able to get off them as an early adult but then still had a bit of extra anxiety now that I didn’t have any help. I used a supplement for a few months to help while working on exposure therapy by myself. I also found if I worked out a few times a week I didn’t need the supplement. I cleaned up my diet and strive for 8 or do hours of sleep each night. The sleep is huge to my mood.
I’m still not perfect but have a good therapist to help with old core wounds.
Also wanted to warn anyone on meds or going to try to be PLEASE be extremely careful with benzodiazepine (Adivan, Lorazepam) They are extremely addictive and the withdrawals when not done carefully are crazy. I know if someone who had a hell of time stopping them suddenly do to flu issues and not being able to keep them down. Even when tapered it’s a pain in the butt. Don’t believe me no problem but look into others stories online. Do what you want with your health but keep yourself informed by looking up these drugs.
I was once to the point of taking meds for the morning and meds to get me to sleep. Looking back now I wish I never was. It got me through school but if you can eliminate your triggers or set firm boundaries it can help to reduce the over all load of stress on you.
For short term help I think meds have a place. However long term they stop becoming as effective and you need more and more and others to counteract the others. Try to use them for as little as needed with the guidance of your doctor. Always talk to your doctor who hopefully has a clear mind on this. I’m not a doctor and not medical advice. You need to do your own research. At the end of the day you are the only one responsible for what goes in your body.