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	<title>JoBlog &#187; Depression</title>
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		<title>Just an update</title>
		<link>http://www.joanslow.com/posts/2008/just-an-update/</link>
		<comments>http://www.joanslow.com/posts/2008/just-an-update/#comments</comments>
		<pubDate>Mon, 14 Jul 2008 20:48:40 +0000</pubDate>
		<dc:creator>Jo</dc:creator>
				<category><![CDATA[Depression]]></category>
		<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://www.joanslow.com/posts/2008/just-an-update/</guid>
		<description><![CDATA[As it says, just a quick update for those of you who actually know me, and use this as a way to keep a vague eye on my comings and goings.

Buproprion is still wonderful, although side effects are a bit of a pain (the timing of the second dose most days either leaves me unable [...]]]></description>
			<content:encoded><![CDATA[<p>As it says, just a quick update for those of you who actually know me, and use this as a way to keep a vague eye on my comings and goings.</p>
<ol>
<li>Buproprion is still wonderful, although side effects are a bit of a pain (the timing of the second dose most days either leaves me unable to sleep, or with a headache) but at controlling my mood it&#8217;s doing remarkably well, considering the circumstances.</li>
<li>David and I split up in May, and we&#8217;re in the process of vacating the house, and I&#8217;m moving in with my parents. I will still be working in Cambridge.</li>
<li>My Gran has broken her arm, and about a week later been taken into hospital because she was bringing up blood. No news on what&#8217;s wrong as yet, and it doesn&#8217;t affect me directly, but the strain on my parents obviously gets partially passed on.</li>
<li>It&#8217;s coming up to my year end at work (31st July) so my days are hectic, stressful, and nowhere near long enough! We&#8217;re also trying to prepare for a colleague to go on maternity leave, and my fixed term contract ends on 1st August, and has not yet been renewed.</li>
</ol>
<p>All in all I&#8217;m stressed, tired and obviously struggling, but the buproprion seems to be stopping me from descending into a complete gibbering, crying wreck. I am having some trouble with anxiety, and I worry that the drugs are making me numb to some of the pain, meaning that I might have to deal with it at a later date. But for now I&#8217;m functioning, more or less, and I&#8217;m thankful for anything I can get.</p>
<p>On a more positive note, I have decided to study for the CIMA Certificate in Business Accounting. It&#8217;s 5 papers, each of which is a multiple choice exam, and I&#8217;m teaching myself. I&#8217;m part way through what I think will be the hardest (Fundamentals of Ethics, Corporate Governance and Business Law), and the plan is to have them completed by about March next year. My train journies are providing perfect half hour sessions, and I am hopeful that I have the motivation to see this through.</p>
<p>I can&#8217;t think of anything else momentous happening to me at the moment, so I will leave it there, except to say that I hope your lives are a little happier and a little less stressful than mine at the moment. TTFN.</p>
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		<title>Buproprion</title>
		<link>http://www.joanslow.com/posts/2008/buproprion/</link>
		<comments>http://www.joanslow.com/posts/2008/buproprion/#comments</comments>
		<pubDate>Wed, 30 Apr 2008 12:05:15 +0000</pubDate>
		<dc:creator>Jo</dc:creator>
				<category><![CDATA[Depression]]></category>
		<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://www.joanslow.com/posts/2008/buproprion/</guid>
		<description><![CDATA[My currect medication cocktail:
800mg Lithium (Priadel)
125mg Lamotrigine
300mg Buproprion (Zyban)
Buproprion Hydrocloride is very commonly used in the US, under the name Wellbutrin.  In the UK however, Buproprion is only licensed as an aid to smoking cessation (under the name Zyban). This means that it is rarely prescribed, as doctors have to prescribe off label, and [...]]]></description>
			<content:encoded><![CDATA[<p>My currect medication cocktail:<br />
800mg Lithium (Priadel)<br />
125mg Lamotrigine<br />
300mg Buproprion (Zyban)</p>
<p>Buproprion Hydrocloride is very commonly used in the US, under the name Wellbutrin.  In the UK however, Buproprion is only licensed as an aid to smoking cessation (under the name Zyban). This means that it is rarely prescribed, as doctors have to prescribe off label, and this generally makes them nervous! Thankfully, seeing a consultant has some benefits as he has the experience to be happy to write those prescriptions, since we&#8217;re running out of alternatives.</p>
<p>I have been taking buproprion for about 6 weeks now. 4 weeks on 150mg once a day in the morning, and then increasing the dose to 150mg twice a day, one in the morning, one at lunch.<br />
The initial side effects from Zyban were unpleasant to say the least. I felt terrible for the first few days, but thankfully it improved quite quickly. The main effects were nausea and decreased appetite, as well as very disturbed sleep. I originally took it at lunch time but got very little sleep, in part from not being able to drop off, and in part from nightmares disturbing me when I was asleep. Moving the dose to first thing helped a lot, and it quickly improved. The nausea improved after about 3 days, but my appetite has been slightly suppressed ever since (although it is helping me to lose weight!).<br />
After 4 weeks we thought it might be helping, so the dose was doubled. It has to be taken in a split dose, so morning and lunch seemed the most obvious option.</p>
<p>I think it is working for my mood really quite well. And the original side effects of nausea and disturbed sleep have reduced to a level such that they are not noticable day to day. Other side effects which started with the dose increase are more of a problem though. I&#8217;m sweating much more, I have daily headaches (which although fairly mild are not pleasant) and there&#8217;s a constant ringing in my ears, although I can only hear it when I&#8217;m somewhere quiet, for example trying to sleep.</p>
<p>Overall, I like Buproprion. The improvement in my mood is well worth a few annoying side effects and feeling tired. I&#8217;ll see how things go for the next few weeks, but I am hopeful this will work and I&#8217;ll be able to put off the dreaded MAOIs for a bit longer.</p>
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		<title>Changes</title>
		<link>http://www.joanslow.com/posts/2007/changes/</link>
		<comments>http://www.joanslow.com/posts/2007/changes/#comments</comments>
		<pubDate>Sun, 01 Jul 2007 18:16:02 +0000</pubDate>
		<dc:creator>Jo</dc:creator>
				<category><![CDATA[Depression]]></category>
		<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://www.joanslow.com/posts/2007/changes/</guid>
		<description><![CDATA[In response to my complete lack of posting recently (Had too much else to worry about) comes a round-up post to bring everything back up to date.
Firstly, I am no longer a student. After five years I am now the proud holder of a 3yr BSc in Biochemistry, 2:2. It&#8217;s not the greatest result ever, [...]]]></description>
			<content:encoded><![CDATA[<p>In response to my complete lack of posting recently (Had too much else to worry about) comes a round-up post to bring everything back up to date.<br />
Firstly, I am no longer a student. After five years I am now the proud holder of a 3yr BSc in Biochemistry, 2:2. It&#8217;s not the greatest result ever, but considering that I only completed 1.75 of a total of 4 course units this year, it&#8217;s something close to a miracle! I think I mostly have Dr Fairweather to thank.<br />
David and I have found a house in the Cherry Hinton area of cambridge, and we&#8217;re going through the final application process.  We move in on August 7th.<br />
I am applying for jobs in Cambridge, mostly looking for something to pay the rent, but hoping for a job at least partially involving events planning. No luck so far, but I have plenty of applications in.<br />
And finally, no roundup would be complete without a report of my current depression situation. I have had my appointment with the Maudsley, which has been useful in a number of ways. Firstly it acts as a second opinion, confirming the diagnosis of treatment resistant clinical depression, and ruling out other problems, such as psychosis or manic depression. And second, they made suggestions about which drugs I should be trying, and at what doses.<br />
We have dropped the Prozac, as it was giving me daily headaches, and had no appreciable benefits. The Maudsley have suggested that both the Trazodone and Lamotrigine should be at much higher levels. We are awaiting a blood level for lamotrigine, which takes forever, but have been increasing the trazodone fairly rapidly. Current side effects are confusion, irritability, extreme tiredness and food cravings. I am hoping that once we reach the final dose, some of these will reduce. On a more positive note, the combination does seem to be at least partially working, so a few side effects are worth living with.</p>
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		<title>And then there were 4</title>
		<link>http://www.joanslow.com/posts/2007/and-then-there-were-4/</link>
		<comments>http://www.joanslow.com/posts/2007/and-then-there-were-4/#comments</comments>
		<pubDate>Tue, 13 Feb 2007 11:43:24 +0000</pubDate>
		<dc:creator>Jo</dc:creator>
				<category><![CDATA[Depression]]></category>

		<guid isPermaLink="false">http://www.joanslow.com/posts/2007/and-then-there-were-4/</guid>
		<description><![CDATA[Apparantly, according to my consultant, we have exhausted the possibilities of 3 drugs at once, and have therefore moved onto 4. These being 1g Lithium, 75mg Lamotrigine, 20mg Clomipramine and 20mg Prozac (Fluoxetine).
Reducing the dose of Clomipramine has certainly helped a lot with the side effects. I can think a lot clearer and the constipation [...]]]></description>
			<content:encoded><![CDATA[<p>Apparantly, according to my consultant, we have exhausted the possibilities of 3 drugs at once, and have therefore moved onto 4. These being 1g Lithium, 75mg Lamotrigine, 20mg Clomipramine and 20mg Prozac (Fluoxetine).<br />
Reducing the dose of Clomipramine has certainly helped a lot with the side effects. I can think a lot clearer and the constipation is much more managable. However, the addition of the Prozac has led to almost daily headaches. I expected them, as they happened last time, and I&#8217;m hoping they will diminish as my body gets used to the drug.<br />
On a more positive note, I am being refered to the Affective Disorders Group at the Maudsley Hospital in London. They are world experts in treating treatment resitant depression, so I hope that they may be able to help me beat this illness.</p>
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		<title>New Year, same old Jo.</title>
		<link>http://www.joanslow.com/posts/2007/new-year-same-old-jo/</link>
		<comments>http://www.joanslow.com/posts/2007/new-year-same-old-jo/#comments</comments>
		<pubDate>Mon, 15 Jan 2007 17:08:46 +0000</pubDate>
		<dc:creator>Jo</dc:creator>
				<category><![CDATA[Depression]]></category>
		<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://www.joanslow.com/posts/2007/new-year-same-old-jo/</guid>
		<description><![CDATA[Appologies for the lack of updates for the past few months. I&#8217;ve been having a fairly terrible time with the depression, and that kinda saps your enthusiasm for pretty much everything else.
So here&#8217;s a quick update on the medication situation.

After coming off the olanzepine, we increased the dose of clomipramine to 60mg
Since this didn&#8217;t help [...]]]></description>
			<content:encoded><![CDATA[<p>Appologies for the lack of updates for the past few months. I&#8217;ve been having a fairly terrible time with the depression, and that kinda saps your enthusiasm for pretty much everything else.<br />
So here&#8217;s a quick update on the medication situation.</p>
<ul>
<li>After coming off the olanzepine, we increased the dose of clomipramine to 60mg</li>
<li>Since this didn&#8217;t help with my mood, we have since added Lamotrigine, which is an anti-convulsant mood stabiliser, which can have some augmentation effects when used with antidepressant treatment.</li>
<li>I started on 25mg, increasing to 50mg and then 75mg over a period of a number of weeks &#8211; for safety reasons, you can&#8217;t increase the dose any quicker.</li>
</ul>
<p>So, that&#8217;s where I&#8217;m at. I completed one module last term, but I had to drop the second module because I was not well enough to attend the lectures, let alone do the coursework. I can still theoretically graduate if I complete the remaining 2 modules, and a six week practical after Easter. This is obviously going to be difficult though.</p>
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		<title>Olanzepine is no more</title>
		<link>http://www.joanslow.com/posts/2006/olanzepine-is-no-more/</link>
		<comments>http://www.joanslow.com/posts/2006/olanzepine-is-no-more/#comments</comments>
		<pubDate>Mon, 23 Oct 2006 19:17:24 +0000</pubDate>
		<dc:creator>Jo</dc:creator>
				<category><![CDATA[Depression]]></category>

		<guid isPermaLink="false">http://www.joanslow.com/posts/2006/olanzepine-is-no-more/</guid>
		<description><![CDATA[Increasing the olanzepine caused an increase in side effects, with no noticeable improvement in my mood, so I&#8217;ve come off it cold turkey, as recommended by my consultant. So far I haven&#8217;t noticed a drop in my food cravings, but I do seem to have acquired a permanent and rather nasty headache. The plan is [...]]]></description>
			<content:encoded><![CDATA[<p>Increasing the olanzepine caused an increase in side effects, with no noticeable improvement in my mood, so I&#8217;ve come off it cold turkey, as recommended by my consultant. So far I haven&#8217;t noticed a drop in my food cravings, but I do seem to have acquired a permanent and rather nasty headache. The plan is to increase the dose of the clomipramine as soon as I feel well enough.</p>
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		<title>Olanzepine and Blueberry pancakes</title>
		<link>http://www.joanslow.com/posts/2006/olanzepine-and-blueberry-pancakes/</link>
		<comments>http://www.joanslow.com/posts/2006/olanzepine-and-blueberry-pancakes/#comments</comments>
		<pubDate>Tue, 17 Oct 2006 12:51:42 +0000</pubDate>
		<dc:creator>Jo</dc:creator>
				<category><![CDATA[Depression]]></category>
		<category><![CDATA[Food]]></category>
		<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://www.joanslow.com/posts/2006/olanzepine-and-blueberry-pancakes/</guid>
		<description><![CDATA[My mood is up and down at the moment like the proverbial yo-yo, and as a result my consultant has asked me to increase my olanzepine dose to 5mg daily. We&#8217;re trying to prove that it won&#8217;t help so we can abandon it for good. Of course, it might help, so we&#8217;ll have to see.
On [...]]]></description>
			<content:encoded><![CDATA[<p>My mood is up and down at the moment like the proverbial yo-yo, and as a result my consultant has asked me to increase my olanzepine dose to 5mg daily. We&#8217;re trying to prove that it won&#8217;t help so we can abandon it for good. Of course, it might help, so we&#8217;ll have to see.</p>
<p>On a more positive note, I attended <a href="http://www.ellythompson.co.uk">Elly</a> and <a href="http://blog.meriwilliams.com">Meri&#8217;s</a> <a href="http://www.meriandelly.co.uk">Wedding</a> a couple of weeks ago. It was a lovely day, but the highlight for me has to be breakfast the next morning at Belle and Herbs. I had Blueberry Pancakes, and they were wonderful. I have had strong cravings for Blueberry pancakes ever since, so if anyone has a recipe for them, or knows where I can get some in London, Bishop&#8217;s Stortford or Cambridge, I would greatly appreciate it!</p>
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		<title>More drug changes (there&#8217;s a surprise!)</title>
		<link>http://www.joanslow.com/posts/2006/more-drug-changes-theres-a-surprise/</link>
		<comments>http://www.joanslow.com/posts/2006/more-drug-changes-theres-a-surprise/#comments</comments>
		<pubDate>Mon, 09 Oct 2006 11:04:13 +0000</pubDate>
		<dc:creator>Jo</dc:creator>
				<category><![CDATA[Depression]]></category>

		<guid isPermaLink="false">http://www.joanslow.com/posts/2006/more-drug-changes-theres-a-surprise/</guid>
		<description><![CDATA[So the happiness lasted about 4 weeks, and now I&#8217;m back to the old familiar feeling of hating life, and struggling to cope. The current drug changes are to increase the dose of clomipramine, as much as my body will tollerate. I&#8217;m currently on 40 mg daily, and the main side effects are a hand [...]]]></description>
			<content:encoded><![CDATA[<p>So the happiness lasted about 4 weeks, and now I&#8217;m back to the old familiar feeling of hating life, and struggling to cope. The current drug changes are to increase the dose of clomipramine, as much as my body will tollerate. I&#8217;m currently on 40 mg daily, and the main side effects are a hand tremor and dizziness on standing.<br />
I&#8217;m now back at uni, starting my final year. Things seem to be going fine so far.</p>
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		<title>Drugs, as ever</title>
		<link>http://www.joanslow.com/posts/2006/drugs-as-ever/</link>
		<comments>http://www.joanslow.com/posts/2006/drugs-as-ever/#comments</comments>
		<pubDate>Mon, 24 Jul 2006 22:24:03 +0000</pubDate>
		<dc:creator>Jo</dc:creator>
				<category><![CDATA[Depression]]></category>
		<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://www.joanslow.com/posts/2006/drugs-as-ever/</guid>
		<description><![CDATA[I am currently taking 1g Lithium, 25mg clomipramine and 2.5mg olanzepine. Olanzepine is an atypical anti-psychotic, which has antidepressant properties at low doses. So far, it&#8217;s given me a very dry mouth. The clomipramine has been increased from 20mg, and the headrushes are worse, and it&#8217;s making me more tired (the olanzepine can also do [...]]]></description>
			<content:encoded><![CDATA[<p>I am currently taking 1g Lithium, 25mg clomipramine and 2.5mg olanzepine. Olanzepine is an atypical anti-psychotic, which has antidepressant properties at low doses. So far, it&#8217;s given me a very dry mouth. The clomipramine has been increased from 20mg, and the headrushes are worse, and it&#8217;s making me more tired (the olanzepine can also do this). The aim is to get to 30mg, and then see what happens.<br />
One a happier note I passed all the exams I took this year. Just one to take in September, which I defered from earlier in the year.</p>
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		<title>Clomipramine</title>
		<link>http://www.joanslow.com/posts/2006/clomipramine-2/</link>
		<comments>http://www.joanslow.com/posts/2006/clomipramine-2/#comments</comments>
		<pubDate>Fri, 26 May 2006 14:00:59 +0000</pubDate>
		<dc:creator>Jo</dc:creator>
				<category><![CDATA[Depression]]></category>

		<guid isPermaLink="false">http://www.joanslow.com/posts/2006/clomipramine-2/</guid>
		<description><![CDATA[Flupenthixol has been discontinued, as any intial effect has not continued. I am starting 10mg daily of Clomipramine in addition to the Lithium and Edronax I currently take. 10mg is a very low dose, which is necessary due to drug interactions. Also, I reacted badly to Imipramine, which made me feel terrible for the few [...]]]></description>
			<content:encoded><![CDATA[<p>Flupenthixol has been discontinued, as any intial effect has not continued. I am starting 10mg daily of Clomipramine in addition to the Lithium and Edronax I currently take. 10mg is a very low dose, which is necessary due to drug interactions. Also, I reacted badly to Imipramine, which made me feel terrible for the few weeks I took it (they have a very similar chemical structure). It could take 4 weeks to have an effect, which I&#8217;m dreading, but at least we&#8217;re doing something.</p>
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