It has been a month since I maxed out my Wellbutrin dose. Within several days of increasing the dosage I began to feel a little better, and that mild improvement has remained though I don’t think I gained much more after that first week. Over the past month I have been able to better manage my anxiety, or more accurately there has been less anxiety to manage, so I have felt better, but not as good as I would like to feel. I have been tossing around trying the Zoloft experiment, but the Mrs. and I have been talking more and more about a second child. The likely Zoloft side effects could make the conception process a lot more work than fun.
Walking in the door today I figured that I wouldn’t be making any changes. We talked for a few minutes and the conversation was leading that way when he asked me how I had been sleeping. I told him I had been sleeping fine, but the pressure of getting up early was gone until spring and that was the real problem. This statement led to a conversation about my anxiety not being and continual experience of being on edge, but rather more isolated events that are quite suddenly triggered by little hiccups in my day. I explained that the larger events will last a while and there are aftershocks for a day or two until my body unwinds from it. Strangely I think this was news to him.
Since he brought it up and I anticipate sleep trouble returning in the spring, the anticipation of it will make it a self-fulfilling prophecy, I asked him about the drug Remeron, mirtazapine, and how it can help for sleep. I was scared of making the change last summer to what perceived as an unknown, to me, class of drugs. I am quite sure I made this point to him clearly so you can imagine my surprise when I found out that Remeron is very similar to Wellbutrin. According to him Remeron is related to Wellbutrin much the same way Paxil, Zoloft, and Celexa are different but similar drugs. How did I miss this last summer? In my exhaustion did I fail to understand this or did he fail to explain it? At this point it doesn’t really matter, but today he made it clear that adding Remeron would be another option for using medication to manage my anxiety. It can be added to my current dosage of Wellbutrin. I will just take it a night to benefit from the sleepy side effect. This is a side effect that he says will only last 4 – 8 hours which is a beautiful working life for my summer sleep problem.
Like everything else related to treating depression and anxiety there is a potential cost. Apparently Remeron has a tendency to increase appetite. This is a potentially problematic side effect as I have documented my weight battle here, and have really been struggling with it this winter. I am hungry all the damn time, get way too little activity, and have slowly crept up six pounds. This should be nothing compared to the thirty-five I lost, but letting a pound or two here and there slip back on is how it starts.
At the end of the appointment I took the prescription and will fill it this week. The plan is to try the drug and see what happens. I am so hungry these days I am not sure I will notice if the pill makes it worse or if I will be able to tell if it is the pill if I am hungry. I guess I will hope it helps with some sleep and anxiety and hope it doesn’t make me fat. How I dislike the decisions this disease forces me to make.