A Day Without Medication...

Is a bad day indeed.

Yesterday I went on an inadvertent medication holiday, and today I am paying the price. It was really stupid of me to forget a part of my routine that is so important. Right now I feel like I’ve been run over by a stampede of bulls.

I should know better. Really – I should. But I did medicate myself a little while ago, and I should start to feel a little more normal pretty soon.

Perhaps it would be a good idea to clarify some of this and talk a little about what medications I take and why I take them. Maybe it would make a little more sense as to why the day after a medication holiday can be so calamitous.

First things first: I joke about the ADD I have here from time to time, but in reality it isn’t a laughing matter. It is, in fact, a diagnosable mental illness. It is what those in the mental health community place in the category of an “Axis I” disorder. Some other common mental illnesses in Axis I include depression, anxiety, bi-polar disorder (also known as “manic-depression”) and schizophrenia (those affected are the ones that “hear the voices telling them to do bad things”).

Any Google search on the Axis categories (Axis I, II, III, IV, V) will yield an incredible amount of information. As far as I’m concerned, it is worth reading about, especially if you’re one of the jaded EMS providers that I know who think many of the psychiatric patients we pick up are abusing the system. Sure – some do – they are the frequent fliers - and if you work regularly in a busy system you know who they are. On the other hand, there are many who have trouble and need real help once in a while. Take some time and figure out the difference.

As for my medications, I take Adderall, one of the trade names for Dextro-Amphetamine Salts. I also take Wellbutrin, an anti-anxiety/anti depressant which I need to manage the side effects of the Adderall, the most evident being anxiety which can sometimes present in the form of a panic attack. Both of them are in timed-release form so that I don’t need multiple doses each day.

If I miss either of these medications on any given day, there is no way to predict what will happen. Sometimes I can forego them and have nothing happen. Other times missing either or both medications can have disastrous consequences. And by the end of the day yesterday it was pretty apparent that I’d missed both because I was in a horrible mood. To use the word “cranky” to describe it would have been an understatement. And I woke up this morning with a terrible headache. Only now is the 800mg of Ibuprofen I took starting to work on it, and I took it over an hour before starting to write this.

I have also discovered that I’ve been given the generic equivalent for the Adderall in the last refill I got. It is not as effective as the brand name; I’m having trouble with breakthrough behavior in the later part of each day that I take it. That is a problem because not only is my ability to concentrate gone, but my behavior will sometimes become erratic, almost manic in fact. The interesting thing is that I’ve noticed it happening, and if I work really hard I can get it under control. To do that, however, requires more effort than I can sometimes expend. So to fix it I have a call into the nurse practitioner I see, and hopefully she can change the prescription so that I’m not receiving the generic formulation from here on out.

Dealing with this makes me understand so often why so many will go off of their medications from time to time. It’s hard work to stay compliant, and many medications have really awful side effects, and this can make someone who has to take them question why they do so in the first place. In my case, though, it only takes one day of missing doses of what I’m prescribed to put me back on the wagon.

It is all about living life one day at a time.