More medication changes...

Well, I had a good long meeting with my psychiatrist last night, and I brought my aunt (who is an RN) along with me so she could ask questions on behalf of the family. I find that when you bring family members with you to doctor appointments, the doctor spends more time with you and takes your comments more seriously.

Anyway, we're going to gradually get me onto a new class of medicines. Currently I'm using Effexor XR, which is similar to an SSRI but also acts on norepinephrine; Xanax, which is in the habit-forming benzodiazepine class; and Imipramine, which is in the tricyclic class. Over the next two weeks, I'm going to wean myself completely off of the Effexor XR and the Imipramine, and immediately increase my Xanax from 6mg a day to 8mg a day (which is an almost alarming high dosage). After the two weeks are over, I'll start taking 200mg of Wellbutrin SR a day, then two weeks after that I'll see my psychiatrist again, and he is going to choose an MAOI class of medicine to start me on.

The MAOI class of drugs are an older class of drugs used to treat psychiatric patients for anxiety and depression, they came to market some 20 or 30 years ago. Since then, the newer classes of drugs, like the SSRIs are now used as the first choice for patients. Tricyclics came around in before the MAOIs and are some of the oldest types of drugs used for these problems. But tricyclics and MAOIs aren't often prescribed much anymore. The reason being is that the newer drugs have less side effects, and the side effects they have are less severe, and they also have less problems in regards to complications while taking other types of medicine.

But the MAOIs for the most part still do a better job at relieving the symptoms or causes of major depression and severe anxiety. The drawback is worse side effects; for example, those on MAOIs are also put on a special diet to help compensate for the side effects. Lastly, they can't be used at the same time as tricyclic or SSRI class medicines, so after I am off of these medications, I have to wait two weeks for those medicines to be completely removed from my body.

In the meantime, I will have started the Wellbutrin, which is kind of in a class by itself, known as an NDRI, and from anecdotal stories I have heard works very well. I've also seen evidence that Wellbutrin is chemically identical to Zyban, the anti-smoking pill, so if I'm lucky this Wellbutrin will not only help alleviate my anxiety and depression but will also help me cut down on my smoking.