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.
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
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.
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.
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.
🙂
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.
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.
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.
That makes sense.
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 💜
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.
Maybe that’s why I sleep bad too, I’ll look into that!
Have a good day and take care 🌷
Thanks! You too!
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.
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.
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.
Oh that’s good that you have access to that.
I’m very lucky in that regard.
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.
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.
Yes it can be a pain to get monthly blood tests with the clozapine but for me it seems to be working out.
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…..
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.
That’s fantastic that it’s worked so well!
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.
I hope it doesn’t take too long to find a doc here.
Me too! I kind of found one, but have to wait a long time to actually see them.
Oh that’s annoying.
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.
There’s a lot to be said for stable.
Isn’t that the truth. As much as I hate taking them, I won’t stop for exactly that reason.
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.
I hope the topiramate ends up helping.
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.
Have you found the gabapentin to be very effective?
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
Interesting. I was surprised to see fluvoxamine on that list, given that SSRIs can potentially cause more vivid dreams.
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.
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 😂
That’s good that you’re able to manage without meds.
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.
That makes sense.
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!
Yes, talking is a good thing!
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.
It’s annoying that just because some people abuse certain things, it’s assumed that everyone does.
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.
Yeah, people judge. I’ve heard good things about Buspar.
I had positive responses to Buspar, approximately twenty years ago.