OpenHealth Q&A

Evaluating the Effectiveness of My Psychiatric Medication

**Disclaimer:** I recognize that providing a definitive assessment without a thorough understanding of my personal circumstances and medical background is challenging. My intent is simply to explore whether I should consider alternative treatments or continue with my current regimen. I am a 31-year-old female who has struggled with depression since I was 18. Along this journey, I have also been diagnosed with Borderline Personality Disorder (BPD). This experience has been quite challenging, leading to my college dropout—a situation I hope to rectify in the near future. My mental health issues have deeply affected my relationships, weight (which tends to fluctuate dramatically in alignment with my emotional state), and overall family dynamics, casting a shadow over nearly every key aspect of my life. Throughout my time seeking appropriate care and understanding my conditions, I have developed a significant frustration toward healthcare providers, even to the point of being apprehensive about hospital visits. Hence, I am turning to this platform for guidance regarding my medication before approaching my doctor, as it feels like a daunting emotional endeavor. **Other Health Issues:** - I was diagnosed with lactose intolerance at 17, a condition that took its time to identify. Now, with the help of lactase supplements, my life has improved drastically. - I was diagnosed with polycystic ovarian syndrome last year. - I found out I have endometriosis two years ago after an MRI and a thorough clinical assessment—but I believe the definitive diagnosis requires a laparoscopy, am I correct? - Back in 2018 or 2019, I experienced pulmonary thrombosis shortly after beginning birth control pills. It later came to my attention that I have an elevated factor VIII, although I don’t think I have a significant risk for thrombophilia. **Current Medication Regimen:** - Luvox 200 mg - Venlafaxine (Effexor XR) 300 mg - Bupropion 300 mg - Amato 100 mg - Propranolol 40 mg (to manage hand tremors) - Metformin 500 mg - Spironolactone 100 mg (for acne and hair thinning) - Lactase For several years, my psychiatric medication has remained relatively stable, with few adjustments. I am finding it increasingly difficult to discuss my medication with my current psychiatrist, though I do appreciate her growing emphasis on therapy. **Challenges I'm Facing:** - I constantly feel exhausted to an extent that feels abnormal. This goes beyond typical fatigue; it’s a level of lethargy that makes even basic tasks, like getting out of bed to use the bathroom, feel insurmountable. I dread the possibility that my tiredness could be related to my menstrual cycle, but it's a stark contrast to how I recall feeling in the past. Watching others thrive only reinforces my sense of abnormality in this experience. - When I’m off my medications, I transform into a person I despise—filled with anger and regret. This medication has been beneficial, yet I wish it could do even more. While I know perfection is unattainable, my concern for potentially exhibiting behavior I would regret profoundly lingers. I am innately quiet and reserved, so my outbursts catch others by surprise. - My sexual drive has diminished, which I personally find acceptable. However, I contend with excessively dry skin and eyes, and occasionally, my mouth feels parched. This irritating symptom feels very real—it’s not in my head! I experience periods of severe dryness that make my skin excessively itchy; it's a frustrating issue. After showering, my skin sometimes burns, prompting me to use specialized soap that has improved my condition but hasn't resolved it completely. Additionally, at night, I sometimes experience uncomfortable sensations in my legs that are difficult to articulate. I can't help but ponder if my medications are contributing to this. Nevertheless, the primary concern remains my persistent fatigue. This debilitating exhaustion has persisted since it first emerged, and I remember the distressing consequences of once discontinuing my medication—resulting in a seven-month period of isolation within my apartment. This experience solidified my understanding that my medication is indeed beneficial, but the level of support it provides does not meet my expectations. 🙏🏻

Answers (1)

6/15/2025, 6:01:35 AM

OpenHealth AI

It sounds like you are navigating a very complex situation with your mental health, and your feelings of exhaustion and frustration are completely valid. You’re looking to evaluate whether your current psychiatric medications are effective enough given your ongoing challenges, particularly the debilitating fatigue. Here’s a structured response to help you consider your next steps.

Key Points:

1. Current Medications: You are on a robust psychiatric regimen which can contribute to both positive and negative side effects.
2. Persistent Fatigue: The level of tiredness you describe seems abnormal and needs further exploration.
3. Potential Side Effects: Fatigue, dryness, and uncomfortable sensations in your legs may be related to your medications.

Explanation:

Your current medication regimen includes multiple psychotropic drugs that can have various side effects. It's important to remember that some medications, particularly antidepressants like Luvox and Venlafaxine, can lead to fatigue or lethargy in some individuals. Additionally, Bupropion is frequently used to counteract sexual side effects from other medications, but it can also have its own effects on energy levels.

The discomforts you describe, such as dry skin and eyes, are common side effects of many antidepressants and psychiatric medications. It's crucial to consider how these medications interplay with your mental health, as well as with your physical symptoms related to polycystic ovarian syndrome and endometriosis.

Next Steps:

1. Monitor Symptoms: Keep a daily log of your energy levels, mood, and physical symptoms (like dryness and leg sensations) for at least two weeks. Include details about your menstrual cycle to identify any patterns that may correlate with your fatigue or discomfort.

2. Assess Medication Timing: Reflect on the timing of when you take your medications. Sometimes splitting doses or adjusting the timing can minimize certain side effects.

3. Hydration and Skin Care: Increase your fluid intake to combat dryness, and consider using a more intensive moisturizer or humidifier to help alleviate skin discomfort, especially in dry climates.

4. Consider a Medication Review: When you feel ready, approach your psychiatrist about your concerns. You could express your observations about fatigue and other symptoms and mention your daily log. Emphasizing therapy as a valuable part of your treatment can help ease your apprehension about medication discussion.

5. Explore Therapy Options: If you haven’t already, engage in therapy that specifically addresses coping strategies and emotional regulation related to BPD. This can complement your medication and potentially enhance your overall well-being.

6. Get a Second Opinion: If your concerns feel consistently unheard, seeking a second opinion from another psychiatrist may provide you with alternative perspectives on your treatment.

Conclusion:

It's understandable to feel apprehensive about discussing your medication due to past frustrations. However, addressing your symptoms with your psychiatrist is crucial for your well-being. You deserve a treatment plan that enhances your quality of life, and taking these steps can bring you closer to that goal. Remember, it's okay to prioritize your mental and emotional health. You are not alone in this process.