To much medication

[eatyourgreens]

Just looking for others opinions on a subject that I am really starting to struggle with.

Medication. I have never really been against medication or anything along those lines. However recently I have started to become a tad concerned with the amount of meds I am on at such a young age.

I take 200mg Clomipramine at night. 5mg olanzapine at night. And 100mg Sertraline in the morning.

All prescribed to me by my psychiatrist for OCD and Depression. And I have been medicated for around 10 years now.

I brought up my concerns with my psychologist recently (Who obviously isn’t trained in medicine), and she suggested it wasn’t unusual and that there shouldn’t be any long term affects. Still not convinced I asked my GP for his opinion and he suggested the same. But I’m still not so sure.

How could we possibly know the long term effects? Surely this can’t be good for my kidneys/liver, let alone my mind. I feel like an addict popping all these drugs.

I’ve tried coming of the medication. But I just crash and burn. And I’ve had very little success with therapy. The thought of being medicated for the rest of my life scares the bejesus out of me.

---------- Post added at 06:01 ---------- Previous post was at 05:59 ----------

I will be bringing this up with my psychiatrist next week. But I just needed to write it all down. Get it out there.

[nicola1980]

Hi this concerns me also, I'm on 187.5mg of venlafaxine and my dose of olanzapine was increased from 5mg to 10mg just over 3 weeks ago, I also take Diazepam at the moment too. I'm being treated for anxiety and depression. If you don't mind me asking how do find the olanzapine? I'm yet to feel the full benefits from my increase ×

[panic_down_under]

I take 200mg Clomipramine at night. 5mg olanzapine at night. And 100mg Sertraline in the morning.

Welcome to No More Panic, :welcome:

OCD is generally the most treatment resistant of the anxiety disorders and is the one which is most likely to need multiple meds to bring under control. That said, I think you definitely should get a second opinion as, imho, there are some potentially serious issues with the combination of meds you're on.

Can you give me a time line on how you got to this point and what prompted each med addition and dose increase. Also, are you on any other medication, prescribed or over-the-counter?


How could we possibly know the long term effects? Surely this can’t be good for my kidneys/liver, let alone my mind.

People have been taking TCAs like clomipramine for 60 years, the SSRIs since the mid to late 1980s and there is little evidence they are as harmful as the disorders they treat. Stress is humanity's major cause of premature death as it sets in train many of our biggest killers including heart disease and some cancers.

However, I think everyone taking antidepressants and other psych meds should have yearly blood and EKG/ECG tests.


I feel like an addict popping all these drugs.

If you were a diabetic, or had epilepsy and taking 3 meds for it would you be asking this question?

Anxiety disorders and depression are as much physical illnesses as diabetes or epilepsy. Actually, they are just differing symptoms of the same physical brain impairment, atrophy (http://www.americanscientist.org/issues/feature/depression-and-the-birth-and-death-of-brain-cells/99999) of parts of two brain regions due to chronic high stress hormone levels killing neurons, or inhibiting the growth of new cells. Antidepressants work by stimulating the growth of new brain cells (neurogenesis) and it is these new cells which produce the therapeutic response, not the meds directly. For a more detailed explanation see: How antidepressant drugs act: A primer on neuroplasticity as the eventual mediator of antidepressant efficacy (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025168/).

BTW-the cognitive/behavioural/mindfulness therapies seem to work by the same neurogenesis mechanism (http://www.biologicalpsychiatryjournal.com/article/S0006-3223(13)00471-X/fulltext) as do Omega-3/fish oil (http://www.ncbi.nlm.nih.gov/pubmed/23746276) supplements and exercise (http://www.dana.org/Publications/Brainwork/Details.aspx?id=43678) to lesser extents.


I’ve tried coming of the medication. But I just crash and burn.

For some of us these can be life-long conditions. I've been on high antidepressant doses pretty much continually for 30 years. Without them I've been unable to set foot beyond the front doorstep, with them I was able to keep a demanding job and have travelled the world.

Can you describe what happened when you tried quitting? How did you taper off the med/s and what happened as and after you did?

[eatyourgreens]

Hi Nicola!..

Olanzapine sent my appetite through the roof. And not in a good way, cakes, lollies, anything and everything sweet. I have put on about 20kg since I started taking it.

Has it helped? Well it knocks me out pretty good. Initially it eased my anxiety however that seems to be steadily coming back. I've got a bad feeling my dose will be upped next week as I'm in a terrible place at the moment.

Edit: Just seen your post panic_down_under. Will get to replying to it now.

[nicola1980]

Fortunately I've not had the weight gain...touch wood, it doesn't make me excessively hungry either which is rare from what I've read lol. Sorry to hear your struggling at the moment, anxiety really is soul destroying and very frightening ×

[eatyourgreens]

Hi panic_down_under!

Didn’t expect to see another aussie on here.

A second opinion? I did ask my GP awhile ago if I could be referred to another psychiatrist. However he wasn’t to keen on the idea as my current psychiatrist is apparently one of the best. He is actually the head of the psych department at one of the top universities in Australia.. Is there anything in particular that I should bring up with him? Anything I should be worried about?

I was initially put on Clomipramine after trailing a couple of other medications for my OCD. That would have been when I was about 15. So I can’t really remember dosages or anything along those lines. I was put on Olanzapine when I was going through a bad bout of health anxiety. I think I was initially put on 2.5mg, and then bumped up to 5mg which I have been on for a couple of years now. Sertraline was for my depression. Half a tablet for two weeks then bumped up to a full tablet afterwards.

I was a tad silly when I stopped my medication. I wasn’t under any medical advise. I went cold turkey. Intrusive thoughts came back with vengeance. And I became extremely depressed, to the point of quitting my job and spending all day in bed. Paired up with all the fun things, couldn’t sleep, nausea, headaches. I had a very and I mean very stern talking to from both my GP and psych, and not to mention from my mother. Wasn’t fun.

Thank you for all the links. Will get some reading down.

[panic_down_under]

.Didn’t expect to see another aussie on here.

We're everywhere, mate :D.


A second opinion? I did ask my GP awhile ago if I could be referred to another psychiatrist. However he wasn’t to keen on the idea as my current psychiatrist is apparently one of the best.

I'd still be insisting on having someone else giving their thoughts. Even the best can be sucked down the polypharmacy rabbit hole unwittingly. If your GP won't play ball just see another one. One of the great things about our health system is that if you have the time and energy you can consult every GP in the land without hindrance, often at no to little direct cost.


Is there anything in particular that I should bring up with him? Anything I should be worried about?

Taking two serotonergic antidepressants from different classes can potentially, repeat potentially, cause serotonin syndrome (SS), especially at high doses, although taking a 5-HT2a receptor antagonist like olanzapine may offer some protection against the more dangerous symptoms. You haven't mentioned anything which would indicate SS is an issue for you, but I'd be wanting a second opinion nevertheless.

The second potential, again repeat potential, issue is all three meds may affect the electrical system of the heart, particular in relation to the QTc interval. You're young and probably fairly fit which decreases the risk (though I note the olanzapine triggered weight gain you've mentioned in an earlier post), but something to be aware of. If you haven't had an EKG in the last few years I'd be demanding one.


I was initially put on Clomipramine after trailing a couple of other medications for my OCD.

It was a good choice, imho. Clomipramine is generally one of the two most effective antidepressants for OCD.


I was put on Olanzapine when I was going through a bad bout of health anxiety. I think I was initially put on 2.5mg, and then bumped up to 5mg which I have been on for a couple of years now.

Olanzapine is basically just a powerful sedating antihistamine in this context which can be effective enough for anxiety, at least in the short-term. However, I do wonder if you still need it given the large antidepressant doses you're on. But perhaps it is those high doses which are keeping it in the med mix.


Sertraline was for my depression. Half a tablet for two weeks then bumped up to a full tablet afterwards.

So clomipramine wasn't effective for depression even at 200mg/day? Odd.


I was a tad silly when I stopped my medication. I wasn’t under any medical advise. I went cold turkey. Intrusive thoughts came back with vengeance. And I became extremely depressed, to the point of quitting my job and spending all day in bed. Paired up with all the fun things, couldn’t sleep, nausea, headaches. I had a very and I mean very stern talking to from both my GP and psych, and not to mention from my mother. Wasn’t fun.

No, it wouldn't have been.

So you have never actually been correctly weaned off meds since you first started taking them, or even tried slowly reducing doses to see if you really need to be on so much? What happened after the cold-turkey isn't necessarily a good indicator of what may happen under controlled conditions.

[eatyourgreens]

Thank you Panic. You've really gone above and beyond with your replies.


The second potential, again repeat potential, issue is all three meds may affect the electrical system of the heart, particular in relation to the QTc interval. You're young and probably fairly fit which decreases the risk (though I note the olanzapine triggered weight gain you've mentioned in an earlier post), but something to be aware of. If you haven't had an EKG in the last few years I'd be demanding one.

This is probably my biggest concern now. As my cholesterol is through the roof. GP wanted to place me on medication for it. However I decided to try and go about things with my diet instead.


So you have never actually been correctly weaned off meds since you first started taking them, or even tried slowly reducing doses to see if you really need to be on so much? What happened after the cold-turkey isn't necessarily a good indicator of what may happen under controlled conditions.

I'm still really struggling mainly with anxiety and depression. Most days I want to just give up. I'm just sick of being scared all the time.

[panic_down_under]

This is probably my biggest concern now. As my cholesterol is through the roof. GP wanted to place me on medication for it. However I decided to try and go about things with my diet instead.

Well exercise is great too, not only for the waistline, but as per above, anxiety too. You don't need to run a daily marathon to get the benefits. A 30 minute walk 4-5 times a week can do wonders for both body and mind. Start small and work your way up. And get the EKG.


I'm still really struggling mainly with anxiety and depression. Most days I want to just give up. I'm just sick of being scared all the time.

If you're on large doses of two antidepressants, plus an antipsychotic and still suffering then, imho, things need to change. Clearly the current treatment regime isn't working. Time to light a fire under your medicos nether regions, me thinks, and get them earning their keep. Drifting is often the biggest impediment to recovery from what I've observed.

Exactly what are you doing with the psychologist? Is it a cognitive and/or behavioural, or mindfulness based exploration of how to cope with your anx/dep and reframe their impact, or are you just endlessly chewing the fat about inanities?