Question about Wellbutrin?

Question

I was taking Wellbutrin for a little over a week and I did not notice it working. I was becoming increasingly more depressed to the point I was thinking about suicide. Today I was reading the pamphlet and it mentioned that the drug can cause suicidal thoughts and to stop taking it. Needless to say I am going to discontinue use. My question is, whay would this happen? If the drug is supposed to make depression go away, why would it make mine worse??? Does anyone know a good antidepressants I can try? Preferably one that also relieves anxiety and compulsive urges?

Answer 1

Bupropion (amfebutamone) (brand names Wellbutrin and Zyban) is an antidepressant of the aminoketone class, chemically unrelated to tricyclics or selective serotonin reuptake inhibitors (SSRIs). It is similar in structure to the stimulant cathinone, and to phenethylamines in general. It is a chemical derivative of diethylpropion, an amphetamine-like substance used as an anorectic. Bupropion is both a dopamine reuptake inhibitor and a norepinephrine reuptake inhibitor. It is often used as a smoking cessation aid.

History

Bupropion was first synthesized by Burroughs Research in 1966, and patented by Burroughs-Wellcome (later Glaxo-Wellcome, and, as of 2000, GlaxoSmithKline) in 1974. It was approved by the Food and Drug Administration (FDA) as an antidepressant in 1989 and marketed under the name Wellbutrin, but clinical trials indicated that incidence of seizure was two to four times greater than other antidepressants and the drug was quickly pulled from the market. It was subsequently discovered that reducing the dose by about half greatly reduced the risk of seizures.

Glaxo then developed a sustained-release (SR) version of Wellbutrin which releases bupropion at a slower rate. The SR formulation is taken twice a day, in order to further decrease the possibility of adverse side effects and seizures. It is also available in generic form (Bupropion SR). Extended Release bupropion, Wellbutrin XL, is the most recent formulation of bupropion and is taken orally once a day. With this altered mechanism of delivery and reduced dosing, incidence of seizures is comparable to, and in some cases lower than, that of other antidepressants. Patients using Bupropion should still be checked for pre-disposing factors that might lead to a lower than normal seizure threshold. It is also important to check for other medications the patient might be using which might also work to lower the seizure threshold.

In 1997, bupropion HCl was approved by the FDA for use as a smoking cessation aid. Glaxo subsequently marketed the drug under the name Zyban to help people stop smoking tobacco by reducing the severity of nicotine cravings and addiction/withdrawal symptoms. It can be used in combination with nicotine replacement therapies. Bupropion treatment course lasts for seven to twelve weeks, with the patient halting the use of tobacco around ten days into the course.

Bupropion is also being investigated for several other disorders including overweight or obesity, Attention-Deficit Hyperactivity Disorder, Restless Legs Syndrome and a possible treatment for increasing sexual functioning in some women. In late 2006, Wellbutrin XL was approved for use by the FDA as treatment for Seasonal Affective Disorder.

GlaxoSmithKline's exclusivity patent ended in early 2004. Prior to this, there were several pantent suits, the biggest of which involved the pharmaceutical company called Andrx in 1999. After an intitial dismissal of the case in 2003, several court appeals by Glaxo resulted in the refiling of the case. The suit is still pending.

International/alternate names include: Odranal (Colombia), Quomen (Thailand), Well (Korea), Zyban LP (France), Zyban Sustained Release (Australia)

Mode of action

Bupropion is a selective catecholamine (norepinephrine and dopamine) reuptake inhibitor. It has only a small effect on serotonin reuptake. It does not inhibit MAO. The antidepressant effect of bupropion is considered to be mediated by its dopaminergic and noradrenergic action. Bupropion has also been shown to act as a competitive α3β4 nicotinic antagonist, the α3β4-antagonism has been shown to interrupt addiction in studies of other drugs such as ibogaine. This α3β4-antagonism correlates quite well with the observed effect of interrupting addiction.

Pharmacokinetics

Bupropion is metabolised in the liver. It has at least three active metabolites: hydroxybupropion, threohydrobupropion and erythrohydrobupropion. These active metabolites are further metabolised to inactive metabolites and eliminated through excretion into the urine. The half-life of bupropion is 20 hours, as is hydroxybupropion's. Threohydrobupropion's half-life is 37 hours and erythrohydrobupropion's is 33 hours.

Chronic hepatotoxicity in animals

In rats receiving large doses of bupropion chronically, there was an increase in incidence of hepatic hyperplastic nodules and hepatocellular hypertrophy. In dogs receiving large doses of bupropion chronically, various histologic changes were seen in the liver, and laboratory tests suggesting mild hepatocellular injury were noted.

Contraindications

* Epilepsy and other conditions that lower the seizure-threshold (alcohol withdrawal, active brain tumors etc.)
* Concomitant treatment with MAO-Inhibitors. When switching medications it is important that there be a short period of about two weeks between the medications in order to reduce risk of complications that might lead to things such as a decrease in seizure threshold.
* Caution with the concomitant use of sympathomimetic drugs (e.g. Ephedrine)
* Active liver damage (e.g. cirrhosis)
* Anorexia and Bulimia which might lead the patient to have a decreased seizure threshold
* Severe kidney disease
* Severe hypertension
* Anxiety disorders (caution), agitated patients
* Pediatric patients (see below)
* Use considerable caution in treating patients where suicide may be a risk (risk is no higher than any other antidepressant)

Side effects

Common side effects include dry mouth, tremors, anxiety, loss of appetite, agitation, dizziness, headache, excessive sweating such as night sweats, increased risk of seizure (Its most controversial side effect, found in 4/1000 during trials), aggressiveness, and both initial and terminal insomnia. Activation of mania and psychosis have both been encountered. Some patients may also require less than the normal dosing which usually starts at around 150 mg for the first few weeks and is then switched to the normal 300 mg dosage; these patients may be kept on the 150 mg regimen.

Suicidal thoughts and attempts have been reported in children and adolescents.[citation needed] Reports of increasing suicidal thoughts have occurred.[citation needed]

Scattered abnormalities of liver function studies are noted, without evidence of hepatotoxicity. Cases of significant liver damage with or without jaundice (icterus) have been seen rarely. In a German database covering side effects, five cases of pancreatitis with elevations of serum-amylase and lipase as well as clinical symptoms (e.g. abdominal pain, anorexia), reversible after termination of bupropion, have been reported. Currently, it is unclear, whether preexisting alcohol abuse or dependence might predispose patients to develop pancreatitis.

Infrequently, dose dependent hypertension is noted. Single cases of myocardial infarction (heart attack) have been noted, but the causal association to the use of bupropion is currently unknown.

The development of mild to moderate skin rashes associated with sensitivity to dye components within the pill coating. This can often be alleviated by simply prescribing a different color pill and consequently, changing the dosage.

Few cases of the urological emergency priapism (painful erection) have been seen. Immediate treatment is necessary, because the untreated patient may totally lose his ability to have erections.

Interactions

Quite a great number of drugs show clinically significant interactions with bupropion. This may be due to interactions with drugs that are metabolized by CYP2D6 as bupropion inhibits CYP2D6 activity. However, bupropion is not metabolized by CYP2D6.

Manufacturer studies have also indicated that bupropion is primarily metabolized to hydroxybupropion by the CYP2B6 isoenzyme. Theoretically, drug interactions could occur between bupropion and substrates or inhibitors of CYP2B6 (e.g. orphenadrine, thiotepa, or cyclophosphamide).

Bupropion is known to lower the seizure threshold. Bupropion, in combination with other medications, has been suspected to induce seizures in some patients with no prior record of seizure activity.[1] While this is not a common side-effect, a growing number of cases world wide validate the need for consideration. It is not uncommon for patients to receive treatment with other antidepressant and/or atypical antipsychotic medications in combination with bupropion. For this reason, care should be taken when prescribing bupropion with other medications prone to lower the seizure threshold. Bupropion has also been known to produce seizures in combination with non-prescription (recreational) drugs such as cocaine, and alcohol. Study the packing insert carefully and ask your prescribing physician about possible interactions.

Abuse liability

In animal studies and small studies with persons having experience with the use of amphetamines or cocaine, bupropion caused drug-seeking behaviour (animal experiments) and was recognized as an amphetamine-like drug by humans. In a scale ranging from placebo on the lower side to benzedrine, it was given an intermediate score indicating moderate likelihood of abuse. In clinical practice, bupropion has been shown that the dose required for significant abuse would cause seizures in most patients. Abuse has not become a significant problem in clinical usage, but the drug should be given with caution to patients with a history of drug or alcohol abuse or dependence.

Dosage

* Depression: usual dose is 300 mg daily, starting with 150 mg in the first few days.
* Tobacco withdrawal: 150 mg initially, may be increased to 300 mg if indicated and directed by physician. In patients also receiving insulin, sympathomimetic anorectical drugs, or antimalaria agents, the daily dose of bupropion should not exceed 150 mg.

Dose forms

Brand and generic pills are available in three forms: immediate release, sustained release (SR), and extended release (XL, ER).
Brand Name Dosage Color
Wellbutrin 75 mg yellow-gold
Wellbutrin 100 mg red
Wellbutrin SR 100 mg blue
Wellbutrin SR 150 mg purple
Wellbutrin SR 200 mg pink
Wellbutrin XL 150 mg white
Wellbutrin XL 300 mg white
Zyban SR 150 mg purple


Overdosage

GlaxoSmithKline has reported that overdoses of up to 30 g or more of Wellbutrin (bupropion) had resulted in seizure in about one third of all cases. Hallucinations, loss of consciousness, sinus tachycardia, and ECG changes such as conduction disturbances or arrhythmias were reported as other serious reactions of overdoses of bupropion alone. Multiple overdoses including bupropion had resulted in fever, rhabdomyolysis, stupor, hypotension, coma, muscle rigidity, and respiratory failure (Biovail Corporation,(June 2006). "Complete Prescribing Information for WELLBUTRIN XL" ).

Additional warnings

Use in pediatric patients

Bupropion has been shown to increase the incidence of suicidal thoughts and attempts in children and adolescents with depression. When treating major depressive disorder in this group of patients, clinical benefits should be weighed carefully against therapeutic hazards. Usually, bupropion is not indicated for pediatric patients under age 18.[2]

Potential indications of bipolar and schizoaffective disorder

The effects of bupropion HCl in treating eleven patients with bipolar or schizoaffective disorder were examined in an open trial.[3] Most patients had been intolerant of or showed minimal to moderate improvement on lithium, neuroleptics, antidepressants, or a combination of these drugs. All patients were maintained on bupropion alone or bupropion in combination with low-dose neuroleptics or anxiolytics for one year or more, with little or no relapse and few side effects. Although these results are encouraging, additional larger studies need to be conducted to confirm this indication (study conducted by G. Wright et al., 1985, published in : J Clin Psychiatry, 1985 Jan;46(1):22–5).

Alleged Risks with certain treatments

In the UK, more than 7,000 reports of potential hazardous side effects have been collected. There have been 44 reports of suspected adverse reactions where there was a fatal outcome while taking Zyban. In reviewing these cases the MHRA state that in the majority of cases the individual’s underlying condition may provide an alternative explanation.[4] More than two thirds of reported deaths were from cardio-vascular or cerebro-vascular causes. A case-series analysis showed increased risk of seizure in the population taking bupropion, but no increase in the risk of sudden death.[5] At least 107 cases of serious side effects have been reported in Germany. Wellbutrin is also banned or restricted from use in several countries.[citation needed]

In the UK, bupropion should only be prescribed as an aid in quitting smoking to smokers who have committed to a definite quit date and a prescription will not last more than 4 weeks after this target date. NICE has issued guidance to the effect that if the attempt to quit is unsuccessful the NHS will not provide funding for a further course, for at least 6 months.

In some countries bupropion is approved only as a smoking cessation aid and not for treatment of depression.

Studies of juveniles with depression

A large study gathered the results of twenty-four studies of juveniles with depression. Patients were to take either a placebo (sugar pill) or an antidepressant (SSRIs and others, including bupropion) for one to four months. According to the results, nobody committed suicide in these studies, although two out of every hundred patients became suicidal on a placebo and four out of every hundred become suicidal on antidepressants. Results indicated that the risks of suicidal actions become high for some juveniles. These kinds of juveniles may include patients with:

* Bipolar illness, previously known as manic-depressive illness
* A family history of bipolar illness
* A personal or family history of attempting or committing suicide

Biovail Corporation, (June 2006). "Complete Prescribing Information for WELLBUTRIN XL" )

Answer 2

1

Answer 3

Antidepressants always take multiple weeks to determine how effective they are going to be in any individual patient. Probably the best antidepressants on the market work for no more than 50% of the patients for whom they are prescribed. That's why finding the right antidepressant sometimes takes trials of different classes of antidepressants.

I know it's frustrating to have to wait so long to find out if a particular antidepressant will work for you, but unfortunately we don't have any test at present to determine ahead of time which one will work best for you. Just because a particular medication works well for someone else of your same gender, age and symptoms does not mean that it will work for you, so asking for medication recommendations from anyone other than an experienced psychiatrist is not going to be helpful for you.

If you have had a family member that has been treated successfully for depression, doctors will often start with that medication.

I think it's important to keep in mind there has never been any study that shows that antidepressants CAUSE suicidality. A better way to look at this is that there can be an ASSOCIATION of the use of an antidepressant with suicidality. I believe this is because people who have a tendency toward suicide are likely to be taking antidepressants.

It has been hypothesized (but not proven) that severely depressed people who might manifest symptoms of depression of low energy (lethargy, oversleeping), can be energized by antidepressants, which leads them to activating suicide plans which they'd been too lethargic to implement otherwise.

By the way, I hope you are getting therapy along with medication, as studies consistenty show better outcomes for depression when you are receiving both therapy and medication.

Take care!

Answer 4

The reason they say it may cause suicidal thoughts is because it will start to pull you out of depression and give you more energy. When a person is severly depressed, they usually don't have the energy to actually ACT on suicidal thoughts. When they start taking meds, their energy level will increase and they might act out on that feeling. It will take probably 2-4 weeks before you start feeling the effects of it. I was on Wellbutrin for many months and it seemed to help me. Anyways good luck, and hang in there, you will start to feel better just give it a few weeks!

Answer 5

No drug will work the same way on each person. Plus, sometimes it takes awhile for a drug to work on a person. Never stop taking a prescription drug without first contacting/consulting your doctor. (Call your doctor NOW. He/she should have an answering service that can contact your doctor or his back-up for you.) (Or second best, your pharmacist).

How old are you? Some anti-depressants do cause thoughts of suicide in people under the age of 18 studies are beginning to show. I don't think they know why.

I have been on anti-depressants for over 20 years now. I have what is cause clinical depression (a hormonal imbalance). I have had to change medications several times because they either lost ther effectiveness or the side effects got worse. It's a challange I agree but one worth working on with your doctor/psycharist.

Good luck

Answer 6

Wellbutrin is okay, I was on effexor before and I hated it...made me feel sick and dizzy. I am on Wellbutrin for PTSD and to supplement my meds for ADD. I haven't had a problem with Wellbutrin, although my friend's father had some seizures from it.

Answer 7

When I was taking Wellbrutrin it took about 2 weeks before I really felt it working.It could be just that you are getting frustrated waiting for the medicine to work and so this causes you to get more depressed. I would recommend taking it until you can call your doctor on Monday and as long as the suicidal feelings are too great I would continue and give that medicine time to start working. It needs to build up to a therapeutic level. But call your Dr Monday if you can. Best of luck and stay safe.

Answer 8

You shouldn't stop taking Wellbutrin without speaking with your doctor. Anti-depressants take much more than a week to work. Paxil is a good medication for depression and anxiety. Your doctor is the only one that can recommend something different for you to try.

Answer 9

This is kinda long winded, but provides an intelligent answer to a very good question.

For the record, I did not write this article. It's a series of exerpts from a website that I found.

Read on....

First off, all psychiatric / neurological medications carry a suicide risk. Antidepressants, antipsychotics, anticonvulsants (a.k.a. mood stabilizers), all of them. It's not just SSRIs. However, many of the illnesses have an inherently greater risk of suicide than you'd get from the meds.


But look at those odds and think about how ill you are now. Take into account the odds of your illness killing you.

Lifetime chance of death by suicide:

Bipolar Disorder 15.50%
Mixed Drug Abuse 14.70%
Major Depression 14.60%
Epilepsy1 13.00%
Dysthymia 8.65%
OCD 8.15%
Panic/Anxiety 7.15%
Personality Disorders 5.05%
Alcoholism 4.20%
Cancer 1.30%
General Population 0.72%

In a review of 22 studies—some including patients with bipolar or recurrent unipolar major depression—risk of death by suicide was reduced at least 5-fold, based on an informal comparison of pooled rates in treated versus untreated samples. Based on quantitative meta-analysis, the pooled risk of death by suicide was reduced nearly 9-fold (or by 89%) in patients who received lithium maintenance treatment compared with those who did not. The risk for suicide attempts fell nearly 10-fold in a compilation of 33 studies (Table 2).

For schizophrenia and other primary psychotic disorders, little research exists to indicate that atypical antipsychotics reduce suicide risk. Evidence is emerging, however, that clozapine may offer this benefit, in addition to its well-substantiated clinical superiority in treatment-resistant psychotic illness.

Another study associated olanzapine with a 2.3-fold lower risk of suicidal behavior, compared with haloperidol.

In Depressionland things aren't as cheerful.

antidepressants of various kinds may tend to reduce the risk of suicidal behavior, but any such effect is small and statistically nonsignificant (Baldessarini et al, 2003, unpublished)
tricyclic antidepressants may yield lower rates of suicidal behavior than selective serotonin reuptake inhibitors (SSRIs). Similarly, however, such trends reflect highly variable research methods and inconsistent findings and do not hold up to quantitative analysis (Baldessarini et al, 2003, unpublished).


Some of the above disorders kill in other ways. In addition to the higher suicide rate, epileptics in general have a higher mortality rate. Treating the seizures reduces the risk of death in all of its various forms. And, as it turns out, taking the meds DOES NOT increase the risk of SUDEP or status epilepticus after all. So we're a lot less likely to die if we just take our goddamn meds.




The complex calculus is: how much more likely are you to off yourself sooner by taking a med now than later by not taking anything at all?

I can't answer that question.

You alone can't answer that question.

It takes you, the people around you who have seen how your behavior has changed (whomever you like and trust in these matters, e.g. family, friends, coworkers), one good psychiatrist and at least one good therapist and preferably another counselor of some kind (e.g. a support group leader, a priest / minister / rabbi / spiritual advisor, a competent school counselor, you get the idea).

It doesn't matter what the problem is - major depressive disorder, bipolar disorder, epilepsy, schizophrenia, OCD, panic/anxiety, neuropathic pain - they all suck donkey dong and they can all potentially kill you.

If they are severe enough.

Let's be clear on a few points:

Not all things that make us mentally interesting are fatal.

Not everyone who is crazy needs drugs.

Certain disorders almost always need drugs. Face it, if you're bipolar and/or epileptic, meds are the first line of treatment. I tried going the non-med way and barely got out of it alive.

One of the many problems with the health care "system" in the US is everyone, the patients, doctors and insurers included, wants a quick fix.

But when it comes to the most complicated part of our bodies, the one thing that most defines who the hell we are, there is no quick fix.

Whether you need meds or not, if you're mentally interesting (a.k.a. crazy, mentally ill, sick in the head, loony, nuts, cuckoo, etc.) you will need the following no matter what:

Therapy
Coping tools and skills
A support group
A network of people to check in on you
Regular exercise
A good, healthy diet
Now some tips to help you decide if meds are worth the risk of suicide and other side effects.

It's really a very simple decision.

What sucks less, what you're suffering through now, or all the potential side effects?

If meds are strictly optional, then you can try everything else first.

Let's take depression as an example, because while I think while some people are avoiding meds who really need them, I really think that modern antidepressants are vastly over-prescribed in this country.

There are people taking them who don't need them at all.
There are people taking them at dosages that are inappropriately high.
And some folks are taking far too potent meds (e.g. Paxil (paroxetine) or Zoloft (sertraline)) when a milder med would do (e.g. Prozac (fluoxetine)

Survival guide on how to reduce suicide risk while taking meds

Once the decision has been made to take meds, there are some steps that can be taken to lessen the chances of suicide caused by the meds themselves.

In-patient hospitalization when starting a course of medication if there is a real risk of suicide to start with.

Hospitalization isn't all that bad. No, really, it's not. Read all about my recent experience. http://www.crazymeds.org/Blog/Index.htm

Remember folks, One Flew Over The Cuckoo's Nest was written over 40 years ago. Things have changed a lot. It ain't perfect, but it's not as scary as you might think. My stay in the lock ward was much more like being on a cruise ship than being in some kind of torture camp. And I was involuntarily committed under a 5150 order!

Here's the deal - one of the main factors in drug-related suicide is that when someone is nearly catatonic in a well of infinite hurt waiting for the sweet release of death, they're just too damned depressed to actually do anything about it! And when an antidepressant works just a little bit it gives them enough energy and clarity of thought to accomplish the one thing on their mind. In a psychiatric hospital killing yourself is a much more difficult thing to do.
Of course hospitalization isn't always an option for one reason or another. My one week sojourn would have cost me $16,000 if I didn't have Medicare.

So that's where you rely on your network of family / friends / whomever as well as a minimum of twice-weekly visits with your doctor and therapist. And if you're talking to other counselors, then you'll be doing more than twice-weekly sessions, because the semi-pros don't count in this case, as extraordinarily helpful as they can be.

In other words, if you can't be watched 24/7 in a hospital, then you have to be watched by as many competent, in-the-flesh humans as possible as often as possible. Pets, angels, stuffed animals, internet buddies and fellow nut jobs don't count.

Med compliance. I cannot stress the importance of med compliance. Taking your pills as directed. Every day. The same time of day every day. Get a pill organizer.

One of the biggest problems, especially with kids, is med compliance. If a dose is skipped it's possible to feel like **** the next day. This is really the case with many of the SSRIs, and notoriously Paxil (paroxetine). And Paxil is especially problematic in that skipping doses can cause it to become less effective. You can see where this is going, right?

Skip a dose - feel like **** - take the drug and don't feel as well as before - skip a dose - feel like **** - take the drug and still don't feel right...

This is one of the reasons why Prozac (fluoxetine) is the only modern antidepressant approved for use with kids. Its 9.3 day half-life makes med compliance less of an issue.

If you have any sort of suicidal thoughts, call your doctor and/or therapist immediately! If your doctor isn't available, call 1-800-SUICIDE (1-800-784-2433) or any of the local suicide hotlines you can find at SuicideHotlines.com. Outside of the US find hotline numbers at Suicide Helplines.org If all else fails, there's always 911 or whatever the emergency number is where you live.

Expectations are generally set way too high. This is part of the quick fix mentality that everyone has.

Doctors, patients, patients' families and HMO / insurance company accountants want the meds, and only the meds, to fix the problems right now.

If the problem isn't fixed right now who gets blamed? The crazy person, that's who. That sort of guilt and stress contributes to suicidal ideation. And if they do kill themselves, the drug companies and the medications are suddenly at fault. Certainly not all the people who wanted everyone to get well right away. Oh no, they're never to blame.

Everyone needs to take a deep breath and get some perspective. The numbers I've seen for bipolar disorder are that it takes an average of two years, from initial crisis and diagnosis to some form of reasonable stability. I'll try to find some verification for that, but from what I've seen in support group land and in my own experiences that's a pretty good number. It seems to map well to other severe disorders.

Two years people.

Two years before you can go back to doing whatever it was that you were doing before you flipped out. Or at least something close to what you were doing.

Two years of therapy, eating right, exercising, participating in a support group.

Two years of being on the right meds. OK, some of you need not be on the meds for that long, but there's still going to be a period of being on meds that's longer than a month, that's for damned sure.

See, this is presuming you're on the right meds in the first place. It's a complex process of figuring out what you need, based on your symptoms, your history and various physical markers. at The Amen Clinic Mouse and I had three-hour long evaluations on top of the brain scans.

Now do you expect to get the right meds the first time after a 30-minute visit to an HMO doctor? Maybe you will, maybe you won't. It won't be entirely the doctor's fault if you don't. It's hard to get accurate information from someone in the midst of a psychological or neurological crisis.

I'm amazed that doctors and nurse practitioners get it right as often as they do. Or close enough anyway. But that just goes to show you yet another way that they are vastly smarter than I am, or most other people with these websites, when it comes to making you better. Translating PI sheets into English and giving you tips on how to live your life when your nuts is a hell of a lot easier than actually trying to heal you.

So relax and have some patience, patient. As I wrote in the introduction to this site a severe crisis, regardless of the disorder, is the psychic equivalent of a broken leg. The injury is real, if invisible without the aid of a fancy brain scan. It's not your fault that you're not better tomorrow or next week.

Forget about work, school or similar commitments.

Your only priorities are:



Getting well.

Caring for yourself (get all the help you can with this).

Caring for any children, pets and other dependents (again, get all the help you can)



That's it.

Apply for disability.

Take a leave of absence, a sabbatical, whatever.

**** anybody who tells you to "Get over it" or "Cowboy up" or similar nonsense. And not in the good way.

Two years may seem like forever, but compared to the rest of your life, it's not that long.



Learn about how long it takes for a particular med to work, and what the side effects are like. As in point 5 some people lose all hope when taking an SSRI and nothing happens after a week. Yet most SSRIs take 2-4 weeks to kick in.

Other people fall into despair over the cognitive impairments (i.e. me feel stooopid) from anticonvulsants (a.k.a. mood stabilizers). OK, feeling stupid really sucks. I will be addressing what you can do to counter this side effect. But, really, it takes about a year for your brain to adjust to those powerful, but really wacky meds. Epileptic seizures and bipolar flip-outs do serious damage to your brain, but the anticonvulsants can actually reverse said damage. No, really, they can. While your brain is being fixed it's going to act a little slower than before.

Then there's always the question of finding the right med. That takes time, too. I'm working on articles to help speed up that process. Un then it's often trial'n'error.

Use this site to learn all you can about the meds. Knowledge is power. If you feel empowered about your healing, if you feel more in control about it then things won't seem so bleak and hopeless.