Mood Disorder???? Lamotrigine and Clonazepam??

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GmaFoley
GmaFoley Member Posts: 7,091
edited June 2014 in Mental Health: Because Cancer Doesn't Just Affect Your Breasts

I'm really starting to think I'm missing something here... Any help would be greatly appreciated..

My issue has been the breast pain since rads... the Rad doc seemed to push me out the door after my 3 month check.. not his problem (He thinks)... So tomorrow I'm seeing the surgeon... I haven't seen him since my 3 week check after my two surgeries.. I just want the pain in the breast to stop...
I also saw my PCP this week - I told him I have been waking up in the middle of the night in a panic and chest pains and been bouncing from happy to sad (think that was from the AIs that didn't work well) He doesn't know what to do so now he says that he thinks I have a mood disorder and gave me 2 prescriptions - one for anxiety(Clonazepam) -  The other is a mood stabilizer(Lamotrigine)??? What the heck?

I then called my counselor and met with her today. She thinks he is grasping at straws.. She thinks I'm going through a "sadness" stage where your brain slows and I "over think" or have "deep thoughts". She says this can mimic depression.  She also said it is part of dealing with cancer and all the fears... I haven't tried the prescriptions yet but thinking that they might help... I will wait until the surgeon appt. tomorrow.. If I can get the pain under control, I think the mind will be better.
 I am feeling like I am in a Catch-22 situation.. Has anyone here taken these med and/or heard anything that might help me through this time... 

I am taking a 3 month break from the AIs.. The Onc thinks I might have gotten toxic from being off and on again with three different AIs... 3 strikes and I'm out for 3 months... oh well- I won't have to worry about the SE's for a while.

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  • Cowgirl13
    Cowgirl13 Member Posts: 1,936
    edited December 2011
    Lamotrigine has worked very well for me.  Been on it for two or three years.  Personally, i would have a psychiatric eval in case these aren't the right meds--primary care physicians do not have the training re: psych meds.  go for it.  You deserve it.  Bless you.
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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited December 2011

    I concur. Don't let a primary care doctor prescribe psych meds. There are some great drugs out there to help. Let a psychiatrist sort it out. Good luck to you. Hope you will be feeling good soon.

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  • GmaFoley
    GmaFoley Member Posts: 7,091
    edited December 2011

    One problem... no insurance at the moment.. not sure I can afford another doc bill.. any suggestions?

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  • DFC1994
    DFC1994 Member Posts: 163
    edited December 2011

    I have been on clonazepam 2mg per night for a few months now and have to say it has worked wonders for my mood and my insomnia. I don't have side effects from it either and wake up feeling refreshed.My family Dr prescribes it to me after almost 2 years trying to find something that works.

    I have never heard about the other medicine you mentioned.

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  • jyg
    jyg Member Posts: 198
    edited December 2011

    Lamotrigine is amazing overkill for a first diagnosis of a mood disorder! Clonazepam is a common anti-anxiety med in the drug family as Valium.



    Primary care docs often work with uncomplicated mood disorders, but your PCP is way out of line. A pain management doc might be better suited for you. There are pain meds that work on depressive symptoms, and goodness knows chronic pain can interfere with sleep and contribute to depressed mood.

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  • 1Athena1
    1Athena1 Member Posts: 6,696
    edited December 2011

    GMA,

    It is important to bear in mind that depression, whether situational (as your counselor suggests) or purely neurochemical can be treated with meds either way, although therapy may play a greater role in one instance than in others.  

    Lamotrigine is a mood stabilizer (also neuroleptic) typically prescribed for bipolar disorder, not for depression, unless there is suspicion of manic tendencies. The clonazepam is an anxiolytic that helps as needed - not really with mood.

    I concur with suggestions that you seek a psychiatrist. There are some who have a special interest in people with medical disorders. There are antidepressants that can also help with anxiety symptoms. SSRIs like Prozac, Zoloft, Lexapro and Paxil are frequently prescribed for this purpose.

    I am surprised to see a PCP prescribe lamotrigine - many have not even heard of it. I would suggest asking him why, just to cover your bases. There may be contraindications for SSRIs in  your case - it would be good to double-check.

    Good luck.

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited December 2011

    Jyg... Yes! Yes! Yes!!!!!!

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  • bluedahlia
    bluedahlia Member Posts: 6,944
    edited December 2011

    I take clonazepan .25 mg every night for sleep.  Works wonders and helps relax my muscles.

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  • GmaFoley
    GmaFoley Member Posts: 7,091
    edited December 2011

    Athena: The reason he is thinking mood disorder is because, i the past I have had bad reactions to the depression SSRI's... Most of the turn me mean... as in plotting how to make my kids irritated - mean... This was a long time ago and have been fine since - Again this past problem was brought on by a pain issue... They fixed the pain and I was emotionally stable enough not to have to use anything... The PCP was thinking being I'm bouncing emotionally to the extremes - maybe it isn't depression but something like bi-polar... I talked to the office today and asked for a referral to someone (psych or pain management) who has more experience with this.

    I also saw the surgeon about the breast pain and he said it is just scar tissue and I would have to wait it out.  Said maybe to talk to the PCP about more neurontin... maybe a bigger dose... I feel like a ping pong ball...  I wish I had insurance that would pay for all these bills I'm racking up....

    One step at a time, one day at a time... I have all these drugs lined up in my med chest and not sure what would help.... I just want to start at ground zero and start over, but the pain won't wait for that... Thanks for all your help...

    At the moment I'm on sythroid (thyroiditis). neurontin, tylenol, Vit. D, no soy mature multi, fish oil, and allegra (allergies)...Onc just took me off aromasin 2 weeks ago.. - in the past 3 months I have been on arimidex and femara too...taken off because of bad reactions.. 

    Guess I will take everything into consideration and wait for the PCP to refer me.. I live in a small town with not many specialists..

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  • 1Athena1
    1Athena1 Member Posts: 6,696
    edited December 2011

    Gma - Oh, boy, you have a lot to deal with.

    From what you say it appears as though the moods and irritability are tied to meds or side effects as much as to anything ese. It's hard to parse out what is a medication and what is not....Neurontin, BTW, can have mood stabilizing effects for some people in addition to its use for pain.

    If there is suspicion of a mild bipolar disorder and if your reaction to SSRIs is irritable (which is not itself an indication of bipolarity), other options could be low dose lithium or depakote, although I don't know if they are contraindicated in your case.

    In an ideal world, a specialist would take you off everything and start again, one med at a time to see what's doing what.

    It would be a great idea if a psych. and a pain specialist could get together and see if they can go over your meds and start again, as it were. I am sorry to hear that there are few specialists in your area.

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  • Reality
    Reality Member Posts: 782
    edited December 2011

    When I was first diagnosed with BC, my gyn prescribed Prozac. It works great for me. I still have mild mood swings, but do not get into deep slumps. No other side effects, except that I can absolutely not cry. I can feel sadness over sad events, books, movies, etc....but cannot cry. My oldest grandson asked me if it hurts when I want to cry and cannot - how perceptive of him, as it does. 

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited December 2011

    GmaFoley...As you can see from the responses there are some terrific drugs out there.  However, you need to find a doctor with EXPERIENCE in diagnosing and prescribing these meds.  Honestly, the DH has had an experience with all of the drugs mentioned.  It takes a combo of a gifted doctor and a patient patient, to find the RIGHT combo.  Also, diet and exercise are EXTREMELY important to your health as well.    Good luck!

    I also want to caution those who are taking benzodiazipines...such as the Klonipin.  They are very difficult to withdraw from and SHOULD NOT be taken for long durations.

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  • cooka
    cooka Member Posts: 278
    edited December 2011

     Hi all, links are to an interesting read on psych meds and DSM for those with the time and inclination.  Probably not a big help for you GMA, but I agree with others that if you can swing a second opinion it might be worth it. Hope you feel better.

    http://www.nybooks.com/articles/archives/2011/jun/23/epidemic-mental-illness-why/?pagination=false

    http://www.nybooks.com/articles/archives/2011/jul/14/illusions-of-psychiatry/?pagination=false

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  • apple
    apple Member Posts: 7,799
    edited December 2011

    JYG yes yes yes.

    Be careful - those psych drugs can be impactful.. I'd try a diet change, yoga, meditation, Sam-e, maybe St. John's wort (root)... (which i haven't tried.

    definitely a 2nd opinion.  I certainly believe in following medical protocol but psych meds are something else.

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  • GmaFoley
    GmaFoley Member Posts: 7,091
    edited December 2011

    Thank you Ladies for your help...  Ok, Update here... I have not taken any of those drugs the PCP ordered and told him that I want a referral - I didn't want to play "drug roulette" any more... Then I talked to the surgeon and luckily, it is only scar tissue and nerve pain I am dealing with... He suggested to up the neurontin slowly, because I am so sensitive to meds... so I talked to the doc that ordered that prescription and she is upping it in 100 mg increments... So far so good... I also found some homeopathic pellets that seem to help the anxiety at night - no attack this week so far - they are made by boiron and are: Coffea cruda 30C: "Coffea cruda relieves sleeplessness with worries, overactive thoughts, and hypersensitivity to pain." - amazingly, I slept good last night.  I'm feeling better between these and the neurontin (gabapentin). I think, until I get an appt with the psychologist, this will have to do... Thanks again for all your support... keep the ideas coming..

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  • cooka
    cooka Member Posts: 278
    edited December 2011

    Yay! Glad to hear you are feeling a bit better. I had nerve pain after my mastectomy for a couple of months and massaging the scar line as soon as it started to hurt really helped, bit different from your case tho (but DH would probably volunteer to be your masseuse!) :) Also, I did yoga to really help me focus on deep breathing and opening up my chest (which I think helped with healing). Take care!

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  • GmaFoley
    GmaFoley Member Posts: 7,091
    edited December 2011

    Well, I'm at my next step in my saga... The doc tried to refer me to a psychiatrist and they were full and not taking patients... I'm actually kinda glad. Then I talk to the PCP's office about maybe a pain management doc that could help with the pain AND the emotions... I got a call today - there is actually one doc in town, so there is a possibility that is is full up too... My insurance is maxed out until April, so I'm not sure what I will do... Either way, I know you ladies will be there for me... I thank you now for any encouragement  you give me..

    The NP upped my gabapentin and said she would do that slowly because of my high sensitivity to meds... I am to call her every two weeks to tell her how I'm doing... I find if I don't wear tight clothes (bras) I do pretty well.  I just wear a shelf bra tank top instead..

    I'm kinda down tonight, it is so quiet in the house when no one but me is here. DH is working tonight.

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  • voraciousreader
    voraciousreader Member Posts: 7,496
    edited December 2011

    I am glad to hear that you are working hard at getting the help you need. I hope you will be feeling much better soon. Hope you enjoy a blessed holiday and may the new year be kind to all of us.

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