Depressio/Anxiety worswning. Help!3 meds combo.

[jcepp]

Hello, I'm 44, I was diagnosed with depression about 14 years ago. My regular doctor put me on lexapro 10mg daily. Then we increased to 20mg. About 5 years ago, I started a business. Maybe the strees and responsibilities,besides aging, made my symptoms worse. I started to " Butterfly",.worrying about things out of my control,like future and financial being bad,and became like homeless,ext. I know,is all in my mind, but you guys know,how depression is. As I right now, I'm on .50mg clonazepam+ 150mg bupropion in the morning, then .50mg clonazepam + 5mg escitolopram ( Lexapro generic). I'm feeling better, but little sleepy. Anyone else, is on this 3 meds combo? How do they feel?. Also, escitolopram causes sexual side effect. Thanks,Guys.

[Paxiled]

I'm generally of the opinion that regular docs don't have the expertise to diagnose a mental illness (or much of anything else -- mainly they're the triage in our medical system, sending us to specialists after they narrow things down) or know how to use the drugs used to treat most specialized illnesses such as mental illness again because they are generalists, not specialists.  Some are good at it, most not so good.  As I've often said on here, I'm 64, and when I first started suffering with mental problems general docs didn't treat them at all -- they referred you to a psychologist, and it was the psychologist who decided if you needed meds or not depending on the severity of your problem and how you reacted to therapy.  In your case, you're describing anxiety.  Anxiety does often go along with depression and is very often caused by it, but I'd want to be sure you're depressed and not anxious.  As for the meds, they do poop out.  You were on Lexapro a long time.  When a stressful event occurs, as it did in your case, and it overwhelms you, your med has either stopped working or it never worked in the first place all that well.  I only mention this because you are on an anxiety med, the clonazepam, but it's best if you don't take benzos regularly but only as needed.  They are addictive if taken regularly and very hard to stop taking.  The wellbutrin can be very stimulating, so if your problem is anxiety and not depression, it might not help and might make it worse, but if it is working, then that's an indication the depression diagnosis was correct and the Lexapro just wasn't enough for you.  Another problem is, drugs don't cure what you're going through, they tamp down the symptoms.  Therapy, and it doesn't always or even usually work, but when it does, the problem is gone.  This also happens for all things people do to treat mental illness that doesn't include meds.  Relying on meds guarantees the problem stays around if you aren't also doing something to try to change the way you think about things, such as your insecurity and reaction to stress.  Drugs won't change that part of you, but therapy might.  Being tired is a common complaint when starting meds; it might go away and might not.  The more drugs you take, the more side effects you have.  Sometimes, though, this is the best treatment, as many of us do not respond to therapy or anything else, and many studies show a combination of meds can be better than taking just one.  One of the reasons you might have been put on wellbutrin is that it is known for not having wither weight gain or sexual side effects for most people, and it is also for this reason often combined with an ssri to combat these side effects.  I'm not on your stew, but even if someone is, their brain and body won't respond to it the way yours does necessarily -- this is a very individual thing.  I would say, if it's working, try it out for awhile and hopefully the tiredness will fade.  In the meantime, you might want to get a psychiatrist and if you haven't tried it, get into therapy and see if you can't beat this thing once and for all.  Good luck.

[Paxiled]

I only mention the psychiatrist, by the way, not because I know you're seeing a regular doc or that if you are the doc isn't any good at this sort of thing, but it would seem if you were doing well on one drug and it stopped working, the most logical step would have been to try you on a different med, not three meds, just to see how it went.  

[jcepp]

Hello, thanks for your response.You sound pretty informed about things.And yes, you're correct about what you said.But, i have been seen a specialist.My regular doc, the one who started me on lexapro years ago', suggested i go see a specialist, but again, at that time, the 10mg of lexapro alone, seemed to have worked fine. The, maybe aging, along with stress, and behave and personality issue, made things worse. Not to mention, the sexual side effect caused by ssri. So i started to see a psychiatrist about 2 years ago', and he also suggested personality therapist as you said. The psychiatrist is the one who started me on bupropion xl, trying to avoid the sexual side effect of the ssri. And we've tried several combinations, before bupropionxl, plus clonazapen worked. This two together, because as you said, bupropion alone, wasn't just enough for the anxiety. We even tried bupropion xl, with 5mg of lexapro, trying to reduce or avoid sexual side effect, but no luck with that. Ssri, even ivery small dose, will still cause sexual side effect. As of right now, the best combo and dose, that seems to be working is what i sade above. Yes, i know about the addiction of the clonazapen , if i'm not addicted already, i'm sure i'm not far from there. But soon, i will see another specialist, since my insurance has changed this year. I will ask what meds and dosage could be good. Will keep you posted on that.And thanks again for your response.    

[Paxiled]

Here's a suggestion -- for me, antidepressants made reaching orgasm take forever.  That would seem to be wonderful for the women in my life, but no, that's not true in the real world.  Everyone has something else to do next and it can become painful.  What can help is discovering and telling your partner what really really turns you on.  This is something people, especially because of religious influence, often just don't learn in life or focus on, but sex is a really nice part of life and like anything else we can all get better at it if we try and have a willing partner.  It's very hard to find medication that works, and hard to find therapy that works, and when you do, it's not a great idea to drop it and try something else that might not work at all.  I'm also addicted to klonopin, though that's because when I was put on it I was told to take it twice a day and wasn't told at all about it being an addictive drug.  If you're already addicted to it, I agree, it's past the point of worrying about it if it's helping, the damage is already done, and it only really comes into play when it's time to stop taking it.