Mental Illness Treatment

Taking Psych Meds: I’ll Tell You Mine if You Tell Me Yours

Taking psychiatric medication - graphics of neuron and pills

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.

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.

medication 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 it 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.

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 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:

79 thoughts on “Taking Psych Meds: I’ll Tell You Mine if You Tell Me Yours”

  1. At the moment I’m on quetiapine 150mg I feel this drug saved my life! I take paroxetine 20mg, prn zopiclone and prn lorazepam, I came off mitrazapine in December after two years I’m slowly losing the 3 stone weight gain it caused! Xx

    1. I’ve gained about the same amount of weight since starting my current batch of meds, but hard to say how much is mirtazapine and how much is the quetiapine or lithium. Quetiapine is huge for me too.

  2. Hi, wow. Thanks for sharing. Hugs to you. I’ve been to the place of huge cocktails of meds like you. I experience treatment resistant MDD. Every time I come off of a class of meds like SSRI’s then SNRI’s, Tricyclics and Lithium and many more. When ever I tried to get back on after being weaned off, they don’t work any more. The last straw for my last huge bout of MDD was about 7 years ago was Wellbutrin XL 300mg. It works really well. Very few side effects remain after my body gets used to it, compared to the others. I also take Xanax occasionally when my Anxiety is not manageable, as Wellbutrin does nothing for Anxiety. In some cases it aggravates it. My doctors advise that I should not get off of the Wellbutrin, because it’s their last line of defense. Research does indicate that it works well on treatment resistant depression, thankfully this has been my experience.

    1. I’m glad it’s helped! A combo of Celexa and Wellbutrin helped when I had my first depressive episode, but then when I had my second episode that combo didn’t do much.

  3. I’m also on an antidepressant/mood stabiliser/anti-psychotic mix: clomipramine, lithium, olanzapine. I also take omega 3 and vitamin D supplements. I have to sometimes explain to medical personnel why I’m on a mood stabiliser and an antipsychotic if I have unipolar depression.

    I’m pretty good at compliance, but I also have a dosette to keep track of them as occasionally I forget to take them, or take them but forget I’ve taken them. My dosette is similar to yours. I don’t have a problem with the morning being at the top, but my issue is that I think of the week as running Sunday to Saturday (because of Shabbat), but the box runs Monday to Sunday, which just feels wrong to me somehow

    I also have weight gain. I’m on the boundary of over-weight and healthy weight which annoys me, but there isn’t much I can do about it. All my meds can cause weight gain, although I only noticed it when I was put on clomipramine. But I don’t want to risk becoming suicidal again just to lose a few pounds.

    1. The only time I’ve ever been on a tricyclic was when I was briefly on nortriptyline, but I didn’t feel like it was a good idea to have on hand in case I overdosed on them.

      I definitely agree, weight is small potatoes compared to the risk of not taking meds.

      1. I was actually suicidal when I was put on clomipramine, and I think I did discuss the risk with the psychiatrist, but more modern drugs don’t really work on me. I think that, as I’d reported being suicidal (this was in an emergency appointment after I reported suicidality), we felt that I was dealing with my suicidal thoughts appropriately enough to mitigate the risk and make it worth trying clomipramine.

  4. Hi Ashley, I’m on a steady dose of Mirtazapine 45mg at night, Pregabalin 300mg morning and night and Clonazepam 1mg at night. I have no idea if my little paunch is age/drug or what! But hey ho. The meds help at last after years of this and that since 1995. I still have my typical Borderline moments but guess that’s what happens with longstanding conditions.
    Sharon 💜

    1. I’m so glad the meds help! I tried going up to 45mg on mirtazapine in the past, but I didn’t sleep as well, so I’ve stuck with 30.

  5. Mitrazapine was the first drug that I ever rejected. Generally speaking, I’m fine with meds but the significant weight gain that promised was something I felt unable to deal with at that point in my eating disorder recovery.

    I recently came off Latuda. It was supposed to help stabilize my emotions but I couldn’t handle the side effects and every time my doctor tried to increase the dose, I’d start to have hallucinations. So, no more latuda although I did push through for three years. Mostly because I’m a glutton for punishment.

    I’m currently taking 35 mg a day of Trintellix (vortioxetine). We’re nearly double the max recommended dose, but treatment-resistant depression demands extreme measures sometimes.

    I’m also on gabapentin for pain and nerve problems. 900 to 1500 mgs a day. That one I prn. My doctor is actually very open to prescribing me almost anything I ask for. It can be a problem.

    I can’t take benzos anymore because of the whole overusing them thing, and I miss them. I was using marijuana, but I’m currently off it because I need to determine what’s causing my nausea.

    1. I’ve contemplated Trintellix, because it’s supposed to be particularly helpful for cognitive symptoms, but I’m a bit reluctant to upset the apple cart.

      1. Right? The coming off, and the building back up. Sigh. I will say is that it keeps the worst of the depression at bay a large portion of the time with very little in the way of side effect. The down side is it’s viciously expensive. The only way I can afford it is through the much appreciated assistance of a local charity.

  6. Here are the psyche meds I now take:

    Clozapine / Clauzerile –
    Clonazepam/klonopin –
    Oxcarbazepine/Trileptal

    And also:

    Senna – for constipation due to psyche meds twice a day
    Metoprolol for high blood pressure

    My psyche meds (and other meds) are mandatory for me. It is not an option for me to discontinue any meds. It is sometimes possible to reduce the amount of meds if I am extra groggy or somewhat overmedicated.

    I do feel there is a stigma for taking psyche meds but since I have been doing so since 1985 (different meds than these) I have no choice other than to weather the psyche meds stigma storm. It is not fun to fight stigma, but for me that fight is worth it if I can be stable or relatively stable.

    1. I totally agree. Sometimes doctors are reluctant to start people on clozapine because of the potential side effects, but for people whose side effects are manageable it can work so well.

      1. Also I forgot to add weight gain with all these meds is significant and an on-going struggle. I have managed to loose about ten pounds but that just takes away the weight gain of the last year and doesn’t place me at my weight pre-clozapine. Still working on it but hey let’s be real. If the meds are working, the weight gain is what it is. So be it…..

  7. I have been on clozapine / clauzerile since 2008 with no hospitalizations. This was a game changer for me. Prior I kept getting prescribed anti-depressants that catapulted me into mania – not therapeutic at all.

  8. I’m currently on baby doses of meds because I haven’t been able to meet someone to prescribe new meds since I got back from England. For now I’m on Abilify (20 mg), Seroquel (25 mg for sleep), and Zoloft (50 mg). I have a feeling I may be prescribed Lithium again, but I’m not sure.

  9. I’ve got lithium 600mg 2x a day, zyprexa 2.5 mg 2x a day, and a handful of supplements including D3, B12, a probiotic, and fiber. I have a love/hate relationship with my meds – I don’t want to need to take them, but I know I have to because I love that they keep me stable.

  10. I am currently on aripiprazole 30mg and citalopram 40mg daily. I also take quetiapine 25mg as-needed for irritability. Will start on topiramate 25mg daily soon and once I’m on that one, it may be increased to at most 150mg a day eventually. This is for nightmares and other PTSD symptoms.

    I had no idea people with unipolar depression could or should ever be on the med cocktail you’re on. Thanks for educating me! That being said, I currently have no idea what my mental health diagnosis is at this point and as far as I know, none of my possible diagnoses are primarily treated with meds. I mean, I started on aripiprazole and citalopram when my only diagnosis was autism spectrum disorder. Then came PTSD and DID, then BPD, dependent PD and oh I was at one point diagnosed with recurrent major depression too so maybe that counts as a medicatable condition. I’m currently being treated for PTSD and possible DID again in addition to autism but I have declined to know my diagnosis.

  11. I take 75 mg Amitriptyline, and my Vortioxetine dose is being increased from 5 mg to 10 mg. It’s used as an adjunct/augmenting for my depression and 3 anxiety disorders. I take gabapentin for chronic nightmares.

    Meds I’ve had to discontinue are generic lexapro, Mirtazapine, sulpiride.

      1. Yep, it pretty much modtly stopped my nightmares which used to be multiple times a night for every night. If I do have a nightmare, it’s rare and not as intense. I know the first line med is prazosin but the blood pressure drops it can cause makes it contraindicated for me.

        Here’s some of the other options just in case you know someone who could use it: https://www.uspharmacist.com/article/management-of-nightmare-disorder-in-adults

          1. Maybe it’s a particular thing about that particular SSRI. I don’t understand the psychiatric stuff about neurotransmitters and receptors well enough to understand.

  12. I’m currently not on meds. I tried an antidepressant twice and both times I stopped taking them. I know you’re not supposed to abruptly stop but I did and didn’t have any issues. My main reasons for quitting were a) weight gain (which also happens with contraceptives) b) nausea c) sleepiness. I seem to function okay without meds for the most part. Right now I just take ibuprofen and acetaminophen, usually on a daily basis these days (for bad headaches and cramps). They sound much more complicated when I use the generic terms 😂

      1. Some days I don’t know how I manage without meds, but I’ve been living this way for so long that it’s what I know. I’ve been suicidal in the past, as my depression/major depressive episodes are often situational. Tbh I think I’m a highly-functioning depressed person. Before considering meds I look into holistic alternatives first… I never liked how pharmaceuticals made me feel internally, despite the benefits of medications.

  13. Thank you for prompting people to share their medication regimes – what works and what doesn’t. It seems like a lot of people have similar challenges even if they are taking different meds. Thanks to you for getting the conversation started. One step closer to being a stigma-buster!

  14. I take five medications a day, three for depression and anxiety and two for other medical problems. One of the depression meds is a cross over too as it helps control pain and has proven useful for lessening my worsening diabetic food neuropathy (it truly feels like pins are being stuck in one’s foot when it flare up). Try sleeping through that! And I take one on a ‘as needed’ basis.

    Zoloft (sertraline sp??) I’ve taken it for years, it’s the only anti-depressant I’ve found that truly helps equalize my mood enough that I don’t want to die. They’ve suggested others, but the cost and/or how they reacted with me were not beneficial.
    Trazadone – partially for depression but mostly for insomnia.
    Cymbalta (this is the cross over one). It is an ‘support’ drug for depression according to my psychiatrist, but it’s proven very helpful in pain management; although I’ve gained a fair amount of weight since I started taking it and there are some concerning stomach problems I’m noticing.
    Gabapentin (sp?) For pain management and dealing with my neuropathy. They recently classified that a Class A (?) drug, so now I have to show my ID when I fill the prescription. I want to know what idiot uses it to get high with. Because it’s very helpful for the pain management, but it never gave me even a tiny buzz
    Xanax (strictly PRN) It’s the only one I’ve found that effectively manages my anxiety. Doctors are extremely leery of prescribing it too because it is one that idiots take to get high with, and it’s allegedly addictive. I’ve never gotten addicted, but I monitor taking it too and only use it if I know something will cause me enough anxiety that I have to dull the edge or freak out. I’ve had it stolen before, so now it stays in a place that only I have access to. The world is messed up.

    Besides these I also am on injectable insulin for my diabetes and prescription eye drops for glaucoma. Fun times.

  15. I take Lexapro 15 mg latuda 20 mgs buspar (my favorite as is done wonders for my paranoid anxiety) 30 mg and. .05 klonopin prn… i was for years on prozac and abilify but they stopped being effective. I’m feel i for a good regime right now thankfully as I’m scared to take lithium due to the possibility of toxicity. Don’t even get me started on weight gain ugh but i do like being fairly stable so i take them anyway. I once had a therapist tell me taking psych meds should be no different then say diabetic or thyroid meds. It was eye opening but doesn’t stop overall stigma.

  16. 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.

    1. 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.

  17. 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.)

      1. 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.)

            1. 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.

            2. 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.

  18. 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. :/

    1. 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.

      1. 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).

          1. 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

  19. 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.

  20. 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

      1. 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

          1. 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

  21. 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.

    1. 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.

  22. 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.

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