About twenty minutes after my 4 pm dose yesterday, I had a bad reaction to my most recently added med. It made me extremely dizzy, with spinning vision similar to the way things look when you’re so drunk that you’re about to vomit. I also felt like I was walking in reduced gravity. With every step, I’d sink through the floor a little and then bounce a bit above it, like an astronaut on the moon. Since I knew I shouldn’t be alone if I could fall and hurt myself, I reached out to my parents (who are a vital part of my support system) and went to their house. I brought a bag with me to stay the night if I needed to.
I felt better by 8pm. But I decided to stay the night.
Science, my friend!
I had an experiment to do, and while it could cause the dizziness to come back, it would also tell me what I need to do about the medication.
The scientific method has six basic steps
- Make an observation.
- Ask a question.
- Form a hypothesis: a testable explanation.
- Make a prediction based on the hypothesis.
- Test the prediction.
- Draw conclusions.
I got very dizzy, bouncy, and spinny around 4:20 pm yesterday after taking a dose of Trileptal and Lamictal at 4 pm.
Why did this new medicine, Trileptal, make me dizzy?
Hypotheses: No, I didn’t misspell that! Normally in the scientific method, you only test one hypothesis at a time, but I had three that I could test all on the same day without muddying the water of my experiments.
Hypothesis 1: The med is simply and truly a bad match for me, and enough has built up in my bloodstream that now, every dose after this will result in worse dizziness.
Hypothesis 2: I took the doses too close together and had too much in my system at once (I had taken them only 2 hours apart yesterday).
Hypothesis 3: The Trileptal and Lamictal in my 4pm dose amplified one another and caused the dizziness (Lamictal is my other mood stabilizer). I was suspicious of the Lamictal because, in high doses, it causes a slightly similar effect on my eyes, and sometimes medications amplify one another’s effects.
Prediction 1: If Trileptal building up in my bloodstream caused the dizziness, it would mean that after I take my next dose (I take it 2 times a day) I would get dizzy again.
Prediction 2: If I was taking them too close together, that would mean moving my first dose to an earlier time would solve the problem, and I’d be fine at my 4 pm dose if Hypothesis 3 was false.
Prediction 3: Pairing Trileptal with Lamictal is the cause of the dizziness, and that means if I take an identical dose today as yesterday at 4 pm, I would get dizzy around 4:30 again.
Experimenting/Testing my predictions:
Test 1: Take my first dose today and if I get dizzy, that means the drug on its own is affecting me badly, and I should (while consulting with my doctor) lower the dose or stop taking it.
Test 2: Take my first of the two doses at 12 pm, followed by a second dose at 4 pm. Yesterday, I took the two doses at 2 pm and then at 4 pm, only 2 hours apart. If I’m fine after taking the second dose at 4 pm, then the answer may be that spacing them out further solves the problem.
Test 3: Take Lamictal and Trileptal together at 4 pm, just like yesterday, and if I get dizzy, then Lamictal is the problem.
Conclusion 1: I took my first dose and didn’t get dizzy, so the drug on its own is not causing dizziness.
Conclusion 2: Taking the two doses at 12pm (instead of 2pm) and 4pm does not cause dizziness, so this is the answer to my problem, once I know Conclusion 3.
Conclusion 3: Taking Lamictal and Trileptal together does not cause dizziness.
Solution: Space out the two doses of Trileptal to 12 pm and 4 pm instead of 2 pm and 4 pm.
Problem solved! God, that feels good.
This kind of thinking is vitally important in a journey with any kind of medication. If you have a bad side effect, that doesn’t necessarily mean the drug is wrong for you. Sometimes the combinations or timing of meds may be messing you up. However, if the med is actually wrong for you, it has the potential to cause horrible effects.
I don’t really have any specific advice for when you should take/not take a medication, mainly because I’m afraid to give any. Psychiatric medications all have the potential to help or harm, depending on an individual’s body. Mental health, after all, is physical health. There is always a possibility for horrible effects in the wrong person, and I’ve had heinous experiences with a few meds, one leading to a 3-month manic episode and another inducing a suicide attempt. I don’t want anyone to have effects like that because of advice I give.
Psychiatric drugs have also saved my life. I couldn’t function daily or even survive long without them. I know they’re essential for my personal wellbeing, so I don’t want my writing to lead someone to refuse to try them out of fear. I don’t want you to give up before you’ve begun. Medicine has the potential to improve your life in crucial, critical ways if you truly need it. The key is finding the ones that are right for your specific brain and body’s chemical balance.
The advice I will give is that it is so, so, so important to keep track of all the effects of your meds, good and bad. Please, please, please take notes and report them to your doctor. Some people’s appointments with their psychiatrists are as short as 10 minutes and can be as far apart as three months, so you can’t go in there and talk in a rambling way (if you can help it; sometimes you can’t) like you’re in therapy. That’s not how psychiatrists work anymore (although they did in the past). They are there to prescribe, and you need to be able to communicate all the relevant information about your symptoms since the last appointment. To do that, you MUST write things down. Do not waste your limited time. And you do have the right to ask the doctor to see you more frequently. My experience is that they probably will agree if they can. Your request is a signal to them that you’re not doing as well as they may have thought. Some doctors, especially those in government facilities, have workloads so overwhelming that they’re simply not able, but it’s very worth a try. Advocate for yourself if you need more frequent appointments.
My entire library of psychiatric guidance (the kind I’m comfortable giving) is in the article here, my Ultimate Guide To Psychiatric Medication. I recommend reading it if you have any chronic medical condition that requires taking medication and seeing doctors regularly; it will arm you with the information you need to be a more effective patient and get more productive treatment. Doctors are tired humans, and the truth is that sometimes they’re just trying to get through the day. If the things you tell them don’t help them do their job, the job isn’t going to get done. They are only as good as the information you give them. They also sometimes don’t try very hard. They’re normal humans who have bad days. And something most people don’t seem to know is that your doctor is not your advocate as the patient. You are your best and only advocate as the patient, and it’s up to you to be an effective one. Please read the article I linked above if you’d like to learn how.
This was not a fun, spicy article about the down-and-dirty parts of my illness. This is just a sample of the work that comes from day to day. Most parts of being mentally ill are not dramatic. Most of my experiences with mental illness are boring; details about medications, missing a dose, forgetting a refill (did that one today), waiting on hold with the pharmacy (that one, too), doctor’s office, or insurance company, putting together pill cases for the week, and just trying to get up the energy to take a damn shower. I spend inordinate time literally staring at nothing. It’s as vital to me as eating: it needs to happen regularly in order to fuel my survival. Most of what keeps me alive is plain, boring work.
I know that this probably won’t be a super engaging article for most people, but I still felt it was important to post for those of my readers who are chronically ill or disabled, because to them, this will really mean something.
To the rest of my readers, I promise to be more interesting next time.
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