At my last psychiatry appointment, it was decided that I should take a genetic screening to see how my body metabolizes medications. Today at my follow-up appointment I received the results of the test and it turns out that my body metabolizes anti-depressants and anti-psychotics differently than the vast majority of the population.
This apparently is the reason that I have not seen much in the way of help from the medications that I have been on. Prozac and Zyprexa, which I've been on for about a year are both drugs that my body does not respond to normally, so now we're walking down a whole new path. I'll spend the next couple of months tapering off of these drugs and adding Lamictal to the regimen as the main mood stabilizer. There was only one anti-depressant on the list that my body metabolizes, but it's not covered by my insurance.
Adding Lamictal has to be done slowly, so I'll start on a 25mg dose for 2 weeks, then 50mg for 2 weeks, then 100mg for about a month and then if all goes well, I'll end up at 200mg (if I recall correctly) a day as the therapeutic dose. The literature on Lamictal specifically calls out Methotrexate, which I am also taking for rheumatoid arthritis. It doesn't say what the interactions are, but it does say to make sure your doctor is aware. He asked me if I'm still taking Methotrexate, so clearly he's aware.
All said and done, today starts the changes of up to to five medications. It's another experiment, but at least this time there's a genetic test backing up the decision rather than just a shot in the dark to see if a medication will work or not. Leave it to my body to be abnormal when it comes to metabolizing. I'll be remaining on Klonopin and Prazosin for anxiety at the same dosage throughout this process.
I really hope that I don't have adverse effects with the Lamictal and that it will actually work to make me feel better. I want to be free of this constant anxiety and depression.