Another Week Of Clozapine

It’s time to refill my Clozapine again. I really hate having to do this every week. I spend so much time making sure the pharmacy can find my blood work results (they usually can figure out where they put the paperwork) and making sure my prescription is refilled or called in as necessary. After I’ve been on this medication for six months, I will be able to do this entire process every other week. Then, once I’ve been on it for a year, I get to do this once a month. So there is something to look forward to, it’s just going to take some time to get there. I started taking Clozapine in the beginning of April, so I still have to do this weekly ordeal until the beginning of October. That time can’t come quick enough.

Even though dealing with this charade is very stressful and difficult, the medication has been helpful. I do believe that Clozapine has helped to improve my depression when nothing else was helping. The reason the blood work and weekly scripts have to be completed is to protect me, and anyone taking the medication, from serious side effects that could occur. So far, I’m doing okay, and I hope that the Clozapine will eventually help me, and maybe even help me become stable. Anything is possible.

UPDATE: I received an email from Walgreens letting me know that my Clozapine prescription has been filled and is ready to be picked up. I’m going to go get it tomorrow afternoon. I’m so surprised. I didn’t even have to make sure they found my blood work or explain that I get the prescription every week. This is the first time that they did it all on their own, and I’ve been doing this every week for over two months. This is wonderful news; maybe it will be this easy to get my weekly Clozapine prescription.

How Much Medication Is Too Much?

I take a lot of medication, and I really mean a lot. I take medication for both my mental health and my physical health. I already take Lithium, Tegretol XR, Deplin, Clozapine, Mirapex, Cytomel, Valium, and Inositol all for my mental health. I also take Zofran, Percocet, Depo-Estradiol, and Depo-Testosterone for my physical health. This doesn’t even include my multiple inhalers and breathing treatments. I’m hoping that I can decrease the meds over time. The first medication I want to go off of is the Deplin. It’s really expensive and I don’t think it’s been doing me any good. I have to wait until I’ve been off of ECT for a while before making any changes to my mental health medications.

A doctor told me this past week that a certain medication may help my bladder condition, but it would be a lifelong medication. I laughed, sarcastically, and told her that wouldn’t be a problem for me. I’m already on a lot of other meds that are lifelong ventures, adding one more to that list is no big deal. Plus, it would be awesome if I could eventually stop getting bladder installations done every week. The new medication is called Elmiron, and the problem is that it’s very expensive. The cheapest I found it was $224 a month. Luckily, my aunt found a patient assistance program that I’m qualified for. I have already filled out my portion of the paper work. I will have my doctor fill out the rest of the documents (which isn’t much) and then I can send it in. I’m excited to find out how much this program will help me.

I often wonder how much is too much. It’s hard to get off medications once you start them because everything has to be done slowly in order to know what medication is causing or helping each issue. Most of my medications are for my mental health, but there are still many that I take because of my physical health. Also, a couple of my meds from both physical and mental health are taken only as needed, so I don’t take them every day. For example, I only take the Zofran when I’m nauseous, the Percocet for pain, and Valium for anxiety attacks. I try to take these meds as little as possible; I don’t want to become dependent on them. I’m sure that I’ll always be on medication, but maybe one day I won’t have to take as much as I do right now. I wonder how many other people take as much medication as I do.

Depression Improvements

For me, there are different degrees of severity to my depression. I can only speak for myself, I don’t know if other people experience these levels of depression as well. My depression is getting better, hopefully because of the Clozapine. If that’s true, then the dosage increase should help even more. When I’m really deep into a depression, dealing with the worst of it all, I can barely get myself to get up out of bed or off the couch. I struggle with personal hygiene, I gain weight, I don’t care about things that are normally important to me, and it’s even difficult to feed my dog. Sometimes I cry uncontrollably, other times I’m just crying on the inside. I distance myself from my friends; I stop calling and visiting them. I also stop reaching out to everyone. There are times that I’m not able to express my emotions. For example, I will see a funny movie, I will think it is funny, but I’m unable to laugh. That is really hard to deal with. When my depression is at its worst, I can’t push myself through it no matter how hard I try. I’ve also been struggling with suicidal ideations for many months. It’s always there in the back of my mind.

Right now, it feels as if my depression has begun to improve. I still struggle with personal hygiene, weight gain, expressing my emotions at times, and reaching out to some people. However, I do recognize my improvements. I have been able to reach out to certain friends and even take the time to visit them. Taking care of my dog is no longer an issue. There are times when I still struggle to express emotions, but the fact that I am able to laugh at times is great. The fact that I am able to push myself to do things is a huge improvement. Even though certain things are hard, I have the ability to push myself to do them. It’s better than it was a little while ago when I couldn’t do anything no matter how hard I tried. It’s a big deal that I can notice these improvements. The suicidal ideations are still in the back of my mind, but the thoughts are there a lot less. Those feelings are no longer my first ideas.

I finally have some hope. I do think it’s possible that I can be genuinely happy again one day; I’m just waiting for that day to come. I must have some patience, maybe a lot of patience, but it will happen. I believe that I will have lots of ups and downs throughout my life. This depression is not the end of everything for me.

Standing By My Decision – I Actually Did It!

I was very nervous about my psych appointment yesterday; I was so nervous that I even had an anxiety attack. I’m not used to telling anyone what I want, especially when it’s different from others want. Standing up for my own desires is nerve-wracking for me. I prepared for my psych appointment yesterday by writing down exactly what I wanted to say. I told my psychiatrist that I wanted to stop ECT because it has become too hard on my body and my mind. I’ve been doing ECT for close to a year and a half, and I just can’t take it anymore. I explained my reasons and to my surprise, he was okay with my choice. He explained that he respects my choice; I couldn’t ask for more than that. I’m very happy with the outcome of that appointment.

He gave me several options about what we could do moving forward. He told me I probably wouldn’t like a couple of the options, but he was going to mention them anyway. I’m glad he did mention them (without any pressure). It was nice to see all of my options at once, even though I didn’t like most of them. Together, we decided to slowly increase my Clozapine up to 400mg a night. We will increase the dose by 25mg each week until we reach our target goal of 400mg. We are increasing slowly to hopefully avoid some negative side effects such as dizziness, fevers, and drowsiness. It will take two months to reach our goal. I will see him in three months. This gives me time to get to the target dose and then allow my body to adjust to the dose for a while. I’m really hoping that this change will help. The Clozapine has helped quite a bit so far, I have a feeling that it will continue to help.

My husband pointed out to me that this is the first time that I made my own decision regarding my mental health, and stuck by it. He was proud of me. To be honest, I’m proud of myself. I know it sounds a little ridiculous to be so happy about this decision, but it’s a huge step for me.

Do You Have Negative Thoughts Like I Do?

I always do everything I’m told, and I think it’s catching up with me. I don’t want to cause any problems, but I feel like I need a vacation from my life, from myself, from my health. Just out of curiosity, I’m wondering how many people have had the same thoughts as the following:

I’m always compliant with my medications and my treatments. Sometimes I just want to say screw it all and not take my meds. I wonder how much they’re really helping anyway. What’s the point of taking all these meds without knowing that they are definitely working?
I’m an insomniac. The Clozapine has been helping me sleep for the most part lately, but I still wake up several times throughout the night. Why do I keep forcing myself to fall asleep? For some reason, I’m always hungry when I wake up. Maybe I should try to see if I get tired on my own. I’m an insomniac; I have problems sleeping, not getting tired.
Sometimes, I’m get tired of doing the reasonable or rational thing. On occasion, I just want to do whatever I feel like doing without people saying it’s because of my mental health.

These are just a few of the things that have been going on in my mind lately. I think I’m just a bit frustrated with everything, and I’m wondering if other people have similar thoughts as I do. If others do have these thinking issues, what do you do to get through them?

Psychiatry Appointment

Late tomorrow afternoon, I have an appointment with my psychiatrist. I’m really nervous about this appointment. He is going to go over my Clozapine blood level with me and change my dose. I’ not really worried about that, but I have just decided that I don’t want to do ECT anymore. I’ve been thinking about this for a while now, but I finally made my decision (I think). Right now I’m going every four weeks. So at the very least, I could just start by taking an extra month off and seeing how that goes. If it’s a disaster, then I can think about going back on it.

I wrote down on paper what I want to say to him because I don’t normally stand up for my opinions.I don’t like any type of disagreements. Since I wrote it down, then I know I will be able to say exactly what I want to say. I’m going to tell him, ‘I am no longer willing to do ETC treatments. The stress on my body, the memory loss, and the loss of words in conversations is too much for me. It has been this way for a while. I tried putting it off, but I can’t wait any longer. I’m not willing to do the Ketamine treatments at this time.’ Hopefully I can stick by what I say. There’s a better chance of that happening since I wrote down what to say.’ I’ll let you all know how it goes.

Managing My Health

Sometimes I feel like all I do is go to doctor appointments, pick up my prescriptions, and manage my prescription refills. This week, I have two doctor appointments and another appointment for blood work. That’s about how many appointments I have each week. I feel pathetic. Most of my life is spent attempting to manage my health, especially my mental health.

My current meds are: Lithium 450mg twice a day, Tegretol 200mg one in the am and two at night, Cytomel 37.5mcg in the am, Clozapine 200mg at night, Deplin 15mg at night, Mirapex 1mg three times a day, Inositol 500mg in the am, Depo Estradiol injection weekly, Depo Testosterone injection monthly, Valium 10mg twice daily as needed, Percocet 10mg as needed up to four times a day, and Zofran 4mg once daily as needed. It’s difficult to manage this many medications, but I do it pretty well. I’ve gotten used to it; I’ve developed a system so I get all my meds filled on time without missing a day.

I have an appointment with my psychiatrist on Thursday to discuss my Clozapine dosage. I’ll probably end up with more than one medication change. I’m hoping to get off the Deplin. It’s really expensive and it doesn’t appear to be making a difference. We’ll see what happens on Thursday.

Further Frustration with My Pharmacy

I’m beyond frustrated at this point. I’m so annoyed and pissed off. I’m still having problems refilling my Clozapine. Yesterday, I had to call the pharmacy 6 times. I finally found out that the problem with my prescription is because of the national database. I don’t know what problem the national Clozapine database has found. My blood work is better than it used to be, it’s finally back to normal. My doctor waited a few extra days to write my prescription because he was waiting for my Clozapine level blood test to come back. That test took a few extra days. I usually get my script on Sundays or Mondays, and this time he didn’t write my script until Thursday. Maybe that’s the problem.

I have an appointment to go do my weekly blood work today. Part of me is wondering if I should even get it done since my script from last week hasn’t been filled. I’m out of Clozapine. If I can’t get my script to be filled today, then I have no Clozapine to take. I wonder if there will be bad side effects or withdrawals. I’ve forgotten to take the medication by accident once or twice. When that happens, I usually end up feeling sick to my stomach, more like a stomach pain. I have no clue what to do. I keep calling the pharmacy, but I’m getting nowhere.

Clozapine Refill Frustrations

I started my Clozapine rechallenge on April 3rd; I have now been taking it for close to 8 weeks. My doses have increased slowing over that time. I’ve had some side effects, but nothing that can’t be managed or dealt with. Some of the side effects have gone away over time and others I’ve learned to deal with to the best of my ability.

I just had my Clozapine level taken and the results finally came back yesterday. My level came back at 80, which is very low. I’m assuming that my doctor is going to be increasing my dose, but I’m not sure. I don’t really know where he wants my Clozapine level. A low level is between 50 to 150 ng/mL, 200 to 300 ng/mL is a medium level, and 350 to 450 ng/mL is a high level. I’m pretty sure that the therapeutic level begins 100, which I haven’t reached yet.

Every week I seem to have problems with my blood work and filling my prescription. People at the pharmacy tend to lose track of my blood test results, which they need in order to fill my prescription. I have finally learned that if and when the pharmacy says they haven’t received my weekly blood work, I just need to tell them to look in my file. I thought getting my script filled would be easier now that I’ve figured out that part. However, this week’s prescription has been difficult for another reason. First, my doctor wanted to wait for the Clozapine level results so he knew how much to prescribe. I normally get my script filled on a Sunday or Monday. It’s now Thursday, so I can’t last much longer without a refill. My doctor has called the prescription in twice to the pharmacy. He said that he was on hold for 10 minutes just to leave a message. I’ve called the pharmacy 3 times today regarding this script, and it still isn’t filled.

I don’t know why it’s so difficult to get this prescription. It seems to add a great deal of anxiety to my life every week. I’m actually taking Valium just to deal with this situation. I wonder if it does more good than harm.

Vivid Dreams

Insomnia and other sleeping disorders are common among patients with bipolar disorder. I personally have suffered from insomnia. I have taken Ambien, Lunesta, Seroquel, Trazodone, and other medications over the years to get me to sleep. Right now, the Clozapine I take gets me to sleep and keeps me asleep. It is also common for individuals with bipolar disorder to have very vivid dreams, especially nightmares.

Patients diagnosed with bipolar disorder often have strange and scary dreams. Many of these patients have anxiety in their dreams. Their type of dreams may also change depending on their status, whether they are manic or depressed. My husband tells me that I am very active at night. I tend to talk a lot in my sleep and I also move around a lot. I’m not sure, but I think that this is related to the type of dream I am having.

Nightmares tend to occur more often for those diagnosed with bipolar disorder. Personally, I tend to have very vivid and scary dreams, but if I don’t talk or write about them right away, I will easily forget the dreams. For the past couple of weeks, my dreams have been extremely vivid. Everything seems so real. The dreams I’m having are mostly everyday situations. I’ve actually had a few times when I’ve confused my dreams with real life. The dreams are common occurrences such as disagreements with my husband or family members, difficulties with doctor appointments for my physical health, or problems with pets.

One of the things that suck is that I have been feeling physical pain in my dreams, specifically bladder pain like I feel from my bladder disorder. I wish I could get rid of these dreams. Isn’t it enough that I have to deal with this crap during the day? Why do I have to deal with it again in my dreams? I had a conversation with my husband in one of my dreams. I ended up using that conversation from my dreams in a real life situation. My husband had no clue what I was talking about. It took me a while to realize that what I was talking about actually came from a dream.

I think I should start keeping track of my dreams. Maybe I’ll keep a journal next to my bed. This way I can write down what my dream was about as soon as I wake up. If I wait too long, then I completely forget what it was about. I’m interested to find out how my dreams change based on what episode I’m in.

My Side of the Pole

Bipolar – Mental Health

Tag: Clozapine