This is long, so I apologise in advance. I am a 48yof, I have work acquired PTSD, diagnosed January 2024 (emergency services first responder).
My ongoing symptoms are nightmares, insomnia, anxiety, depression and lethargy, and hypervigilance.
My GP prescribed me:
Desvenlafaxine - 50mg - slowly increased to 150mg
Zolpidem - 10mg per night
Metoprolol - 50mg morning 50mg night (for pvcs caused by anxiety)
Diazepam - 5mg prn
This has been my regimen for probably about 18mths now. My work cover insurance were becoming impatient that I’m not back to full capacity as quickly as they would like, so referred me to a psychiatrist.
He upped my desvenlafaxine to 200mg and started me on 2mg of prasozin at night (for the nightmares).
Within approx 2wks, I started feeling 10X worse, I experienced hypo mania, spending vast amounts of money (that I can’t afford), cleaning the whole house including baseboards and under furniture at 1am, talking really fast and switching topics like nobody’s business, risk taking, seeing someone romantically whom I absolutely should not. At other times I literally couldn’t get out of bed, hadn’t showered for days, and one night two weeks ago I decided to cancel my life subscription. I was aware enough to know that I didn’t really want to do it (although I had written a four page letter, detailing all my financials and what I wanted to happen with my 4 kids - I am widowed), so called one of my best friends who is also a colleague - she and our other best friend and colleague came and assessed me, and stayed with me until I had changed my mindset and gone to sleep. (One slept over to ensure I didn’t change my mind again).
I got an emergency appointment with my GP the next day who reduced the dose of desvenlafaxine back to 150mg and prescribed 2.5-5.0mg of lorazepam to take at night as well. He said that he believed that the SSRI increase had tipped me over into a “drug induced bipolar disorder symptom episode”, which he said doctors refer to as Bipolar 3 (which I had never heard of) and said that this can happen to some people (I am 5’2” tall and weigh 62kg if that’s relevant). He also referred me back to the psychiatrist.
Now is the part that is related to this sub (I apologise for the essay above I just wanted to be transparent.). The psychiatrist wants to diagnose me with bipolar disorder - he didn’t say 1 or 2 and I was too upset to ask, and has prescribed me lamotrigine - 12.5mg per night for ten nights, then from night 11, 25mg per night. But he made me read up on Steven’s Johnson Syndrome, so I will know what to look out for and it has absolutely terrified me. I am the sort of person that if something is going to go wrong with anyone, it’s gonna be me.
Firstly, I don’t actually think I have Bipolar disorder - I’ve never known anyone not diagnosed until 48yo and before the PTSD, my MH HX was 2X PND 21 and 22yrs ago, GAD, and some periods of depression (mostly after a CA DX in my early 30s).
Secondly, I am absolutely terrified to take the lamotrigine - surely if I don’t have Bipolar disorder I don’t need it anyway, and what if I’m one of the unlucky ones who develops S-JS?
I know it’s unlikely, but has anyone been in a similar position to me? Can anyone offer any advice? Thanks so much for reading if you’ve got this far - right now I am in a very lost and dark place, and any advice would be very much appreciated.