Tag: fluoxetine

Double the Pregabalin

Bones

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I started taking pregabalin on the evening of my last day of work last year.  I did this specifically because we had a very busy period in the lead up to Christmas, and I did not want to be in any kind of vaguely altered state during this mad rush.

As it turns out, it was a good idea, as I experienced some fairly hefty dizziness during my first few days on pregabalin.  I was on the lowest therapeutic dose, 75mg twice daily.  My doctor advised that we had room to quadruple my dose, depending on how I responded, and we were

The week before last I had my first week of work experience, and so my first week of doing stuff, while on pregabalin.  75mg twice daily did not quite cut the mustard, and I found myself in quite a bit of pain by day two.  I also found myself with absolutely no energy by the end of each day, making it home as a zombie and crawling onto the couch to put my feet up.

Last weekend I doubled my dose.  This time the first couple of days involved some decent dizziness – nowhere near as dizzy as starting pregabalin, but definitely bad enough that I wasn’t keen to drive, but by the third day I was able to get around confidently.

It was immediately apparent that I had an increase in energy levels.  I have been able to do more during my days without exhaustion setting in.  On Thursday, I was up and moving / working / cleaning from 7am until 9.30pm, and while I was exhausted on Friday, I was no where near as achy and dead as I normally would have been.

I also have a much greater sense of peace and contentment.  Fluoxetine has worked very well for taking the edge of my anxiety and depression.  My resting heart rate gleefully sat at around 80-90, while my standing up and moving around heart rate would range from 95-115.  My heart rate, even lying down, would very rarely dip below 80.  My sleeping heart rate would be 50-60.  For me, these are pretty good values.  Before this I would usually have a resting heart rate somewhere in the 90s.

On amitrip (with fluoxetine), I’d have similar values, except for Tachycardia Monday, where my heart rate would consistently be over 100 (sometimes as high as 125) until about midday, and then it would go back to normal.

On 75mg twice daily pregabalin (with fluoxetine), I had fairly similar values as to fluoxetine only.  On 150mg twice daily pregabalin, my heart rate very rarely goes above 100 (even when I’m standing up and moving around) and typically sits around the 70s when I’m sitting and the 90s when I’m moving.  Sometimes it even goes as low as the 60s when I’m lying around!  Since beginning to wear my Apple Watch (specifically for this reason) almost a year ago, I have not recorded values as good as this.

So not only is there a clear physiological effect of lowering my heart rate (I suspect by some cool actions on my central nervous system), it also has the effect of relaxing me mentally, and giving me a sense of calm, contentment, and relaxed energy I have only really experienced when on a really good holiday.

I am hopeful that this continues for the long term and it’s not just my brain getting used to the increased amount of pregabalin.  If it does, I may have my life back!

Amitriptyline – That’s a No Go From Me

Bones

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I’ve been on 10mg Amitriptyline every evening (along with 20mg fluoxetine every morning), and it has finally settled in enough for me to say, no, this is not working.

It’s one of the more difficult things to do, stop and admit to yourself that this medication that should be helping you (and oh god don’t you wish it was) actually isn’t.  I mean, it sort of is, and sort of isn’t, but the positives are outweighed by the negatives.  Then you have to go back to your doctor and say ‘this isn’t working’ and they pry for reasons why and sometimes it’s hard to put the reasons into words.

Fortunately for me, it wasn’t.  My negative side effects included, but were not limited to:

  • Tachycardia Monday (I wish it was on Tuesday because that would have sounded cooler) – where my heart rate was consistently 100-130bpm for the majority of the morning, every Monday.
  • Consistently higher heart rates across all activities.
  • Intention tremors when I’m tired.
  • Increased anxiety and depression.
  • Increased headaches and visual disturbances.

So I told my doctor and he suggested we halve my dose (I’m already on the lowest dose tablet) and re-visit in a few weeks when he’s had an opportunity to read up on what else might treat fibromyalgia.  I’m pushing fairly hard to try a different medication.

I’ve been on 5mg Amitriptyline for the last week and the change is huge.  I feel excited about things again, I’m happier, more relaxed, and generally more positive.  I don’t have tremors anymore, woohoo!  Everything’s coming up Milhouse!

Except with the lower dose of medication that was managing my pain, I’m now in more pain, which I’m not quite so keen on.  My arms, which haven’t ambiently ached (for no reason) since starting on amitrip are flaring up again.  Usually the aches are confined to my hips, thighs, and lower back.  I’m having random spots on my skin where touch there is excruciating – something as simple as a cable brushing against my arm feels like a fire brand.  Sometimes where I like to sit the sleeves of my cardigan is overly sensitive.  I haven’t been able to wear my watch because it’s been too painful.

You win some, you lose some.  At this point I’d rather this level of pain than trembling so hard I can’t even do up a button.  When I see my doctor next I’ll be pushing for a new script to try, and for a referral to the frightfully expensive (private) pain management specialist he mentioned.  It’s time to get this ball rolling faster!

Take Your Meds

Bones

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I’ve had a couple of seriously stupid days.  I’m laughing about it, because nothing bad really happened, but it could have.

I have alarms I’ve set on my phone with comical noises as a reminder to take my fluoxetine in the morning, and my amitriptyline in the evening.  I would forget my own head if it wasn’t screwed on, so this is a sensible precaution.

Except when it goes off and I don’t immediately take my medication, and then I forget about it.  Like I did yesterday morning.  And yesterday evening.  And this morning.

It was only when I was lying in bed wondering why I was in so much pain and also not trembling that I realised whoops, I hadn’t taken my amitrip the night before!  It wasn’t until 9.30am that I realised I’d forgotten to take my fluoxetine that morning, and it was through a process of thinking ‘now these symptoms are a bit severe for missing one dose, I don’t usually feel this bad when I wake up late’ that I realised I’d also forgotten my fluoxetine the morning before.

The good thing is I can now say with certainty that the amitriptyline really helps.  The bad thing is I now know that I ignore my alarm!  So, on the suggestion of a friend, I got the app called ‘Medisafe’.  This post isn’t sponsored in any way, shape, or form, I just genuinely think it’s a neat app.  You plug in the medication, you select the dosage, and then you select the external presentation of your particular medication (because they vary considerably).  You tell it when you take it, how many you take, and what you take it for, and it then proceeds to piss you right off when you need to take it.  You have to go in and say you took it (which I will only ever do once I’ve actually taken my medication), so hopefully I won’t have any really daft days like the last couple.

Like I say, I’m laughing and making light out of it, but if I hadn’t run home at morning tea and taken my fluoxetine, it probably would have been a different story.  Moral of the story:  take your meds!

Today I Don’t Feel Like Doing Anything (Nothing At All)

Bones

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Today I have no spoons.  I don’t think.  I just don’t care enough to do anything – not in a bad way, mind you, I’m quite mentally alert and with it … I just … can’t be bothered.

I still did stuff.  I walked the dog at the paddock, did my feeding rounds, did some googling on light weight equipment.  I did my exercises, as prescribed by my physio.

Now I’m home and I’m thinking it’d be nice to do some writing (of the fiction kind, not this rambling mess I call a blog) and I can’t be stuffed.  I don’t want to watch TV, I don’t want to read fanfiction (or fiction … or anything).  I don’t want to knit or crochet.

I used to experience this a lot, but with more gloom.  Now I’m just feeling this but there’s a sort of … peace, contentedness almost, with wanting to feel like an amorphous blob for a bit.

I’m wondering if this is how depression is going to manifest now that I’m on anti-depressants, or if I’m just burnt out (new or continuous, who knows!  I’m sure I’ve been burnt out and barreling forward for years).  I don’t know if finding the root cause will change anything, there’s not a huge amount I can do about either depression or burnout other than what I am doing – which is continue to do the things I must, not do things I don’t, drink water, do light stretches (and the daily walkies) and do relaxing things that I enjoy.

Amitriptyline – Two Weeks In

Bones

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I have now been on amitriptyline for two weeks.  Well, I will take my 14th pill tonight.  It hasn’t been quite the upheaval that beginning fluoxetine was, but it has been an interesting time.

I’m on amitriptyline while my doctor is awaiting my blood results to rule out other things that can cause fatigue and muscle pain in a similar manner to fibromyalgia.  It’s used to treat both nerve pain and to improve sleep – sleep being one of the more important factors in determining your ambient pain levels during the day.  It succeeded on both counts!  With some … interesting effects.

The first morning after I began taking amitrip it felt like all my muscles were limp noodles.  Walking was an interesting experience.  My hips swung wide and I caught myself on my dresser, on door frames, on couches …  and it was hard just getting my toast from the plate to my mouth.  Nothing quite wanted to cooperate.

I felt a little spaced out.  Not as much of a space cadet as fluoxetine, fortunately.  I didn’t feel like I was permanently lightly high.  I just felt … lighter.  The physical effects of amitrip definitely contributed to the overall light feeling.  I also slept really well.  For the first week at least.

The second week was a bit rougher.  My sleep became more interrupted.  It was harder to fall asleep on the couch at 8.  It didn’t help that I had a lot more commitments in the evening that week, so I wasn’t able to relax for a bit before dozing off.  I started to feel flat, like I wanted to do nothing and be an amorphous blob again.  I began having difficulties concentrating, my words jumbled up.  I felt sluggish.  My body felt heavy, I was sore.  I still had limp noodle muscles first thing in the morning.

Last night (for reasons I’ll blog about later) I had one of the best sleeps I’ve had in a long while and I am now out of a state of pure exhaustion and into a place of just normal tiredness.  The sluggishness, difficulties concentrating, and issues with words were mainly a result of the fact that I was utterly knackered.  Getting some seriously good sleep took that extreme edge off, leaving me with a more normal tiredness I know how to deal with.

The amitrip still makes my muscles noodles, and it’s lovely, because when I wake up in the morning I am not stiff and in pain.  It leaves me a bit wobbly for a few hours, but that is getting better with the exercises my physio has given me for stability.  I am also definitely sleeping better, although not as well as I did during the first week.  I still wake up during the night, just not as frequently.  I also really notice when I have and haven’t slept well the night before – I notice a huge increase in ambient pain levels through my hips and legs and up my back when I’ve slept poorly.  The amitrip only does so much for the pain.

All in all, it’s been an okay couple of weeks.  I’m hoping things continue to improve now that I’m getting better sleep, and the sluggishness goes away the better rested I get.