Saturday, 26 May 2018

Medication Review

(TW: Discussion of Medication doses and weight gain)

Last Monday, I had my medication review with the CMHT Nurse Prescriber. I was worried about how I'd come across during the appointment, as I was feeling numb and tend to look absolutely fine when I'm like that.

I was quite calm during the appointment, and explained how I'd been feeling, the kinds of mood swings I have, as well as the times when I'm numb. I sort of over-explained how I was feeling too, and told the nurse that I worried I was coming across as if there was nothing wrong with me. She took that into consideration thankfully, and understood the problems that I had.

She asked me what I hoped would come of this appointment, and I said that I wanted the Sertraline to be changed to a different antidepressant (as it doesn't work for me anymore) and my Aripriprazole dose to be raised (as I felt I needed a stronger dose to control my mood swings).

She said that, because I have BPD (Borderline Personality Disorder), my symptoms were mainly linked to the relationships I have, and medication wouldn't help as much as therapy. I worried that she would stop my mental health medication altogether, but luckily she didn't.

The Nurse Prescriber told me that what she thought would be best was to put me on a different antidepressant than Sertraline, in a different category (SSRIs, Tricyclic, SNRIs etc) as a similar one probably wouldn't work. She didn't want to put me on a higher dose of Aripriprazole however, as 10mg was the appropriate maintenance dose for my needs. It is technically an antipsychotic, and as I don't really experience Psychosis, it wouldn't be suitable to raise the dose.

She asked me if there were any antidepressants I wanted to try. I wasn't sure, but she did suggest Mirtazapine. At the time, I knew nothing about it apart from that a few of my friends found it helpful, so I agreed.*

She said she would have a word with the Consultant Psychiatrist and then would write a letter to my GP (CCing me in) with the medication I was to be put on. She also wanted me to see her in 6 weeks, to see if the new medication was helping. After asking if I had any other questions or concerns (I didn't at the time) she ended the session.

*The session went well, but the next day, I looked up Mirtazapine and was shocked to find it was one of the worst antidepressants for weight gain. I am desperately trying to lose weight and putting on weight makes me very depressed, so I was worried about this! I've since had a word with my Support Worker**, who will talk to the Consultant Psychiatrist to see if I can be put on something that doesn't cause (as much) weight gain.

** I will talk about my latest session with the Support Worker in the next blog post.

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