Genetic Test for Medication

When I first started seeing my new psychiatrist she asked me if I’d had genetic testing to determine which medications would work best for me, I hadn’t, so she asked if I was interested. Of course I was interested! I was then given 2 swabs to rub on the inside of my cheeks and off they went to the lab at GeneSight, within a few days the results were back.

You can read a lot more about GeneSight and see an example of what an actual test looks like on their site. To see a detailed example of  test results click here. It will take you to a pdf. I was going to show you some of mine but mine are black and white copies and aren’t nearly as pretty as the actual test results, and mine has over 9 pages of information. (I think some is repeated to give more in-depth information about it, but golly, that’s a lot of information.) I will however talk about some of my results.

Sample of one page of a GeneSight report.

After receiving my results we started going though it all to see what medication therapies would be best for me. It was very surprising to me how many medications I’ve been on in the past that were listed in the “Significant Gene-Drug Interaction” category. I also found out that this test really didn’t show which drugs I would have severe side effects to. For example, all antipsychotics. There are a few that are listed as “Use As Directed” that caused me severe Akathesia (the need to constantly move) and muscle twitching, which can become permanent.

We went through all of the medications on the list for Antipsychotics, Antidepressants, Mood Stabilizers, Anxiolytics and Hypnotics, Opiods and Non-Opiods. I’m not really sure why I was tested for opioids and non-opiods but I will be taking that to the hospital the next time I have surgery. (hopefully that’s never)

I’ve been told I’m a complicated case. I’ve tried a lot of medications in the past, some worked for a while and stopped and some never worked. We started going through one that worked for a while first. Lithium. When we tried Lithium I started to show toxic signs before I got to a therapeutic dose. We tried Depakote, I felt better and got to a therapeutic dose but it caused so many side effects that I couldn’t take it. (my stomach hurt so much and caused me to have severe retching, it was most painful, and this went on while I was on antibiotics so I blamed it on the wrong drug for a long time, finally we figured out what the culprit was and I had to stop it.) So then we tried Vraylar, an Antipsychotic, almost immediately I started having symptoms of akathesia. It wasn’t as bad as it was with Latuda, but it was starting, so I was put on a drug to help control them. It did but I still had this constant hum that made me feel like it was going to start all the time and I was still a little manic. You may remember the post about me talking all the time. I saw my psychiatrist during that time and could not stop talking during that visit, it was most disturbing to me. I can’t even remember what she did to change my medication at that time, I believe she added another medication. I know at one time I was on five drugs from this one person….or was it six? I’m still on a ton, but I’m tapering off 2 so that will make it less and one of those should also take over a medication for a condition I’m being treated for by another physician, so that will take away 3 drugs all together. Score.

I’m sure I’ve completely confused you. It confuses me!

Let’s see if I can make a little more sense than I have been….yes I seriously doubt it too, but bear with me. The last visit I had, I took that gene test and was ready. I told her what I had taken before that seemed to work for a long time, Topamax, all by itself, but we got to such a high dose I has severe cognitive issues, so I’d like to add it to the Lamotrigine I’m already on, both of these are mood stabilizers, that way I don’t have to have such a high does of Topamax and shouldn’t get to the point that I have cognition problems. (I was over 400mg before now I will be at 200mg, much more doable I think) Topamax can also help my migraines and my Idiopathic Intracranial Hypertention, so that’s a great thing.

I’m also seeing another psychiatrist on the 28th for a second opinion. I’m not thrilled by how this has been handled, all the drugs just pushed on me, and at one point when I was at my worst and asked what to do if I was in crisis, I did not feel it was taken seriously. I was told to go to a certain hospital, but was not given the information. How is someone who is in the throws of a severe mixed mania episode supposed to remember what psychiatric hospital this woman spoke of to find out how to get there, and I was not in the frame of mind to ask her to write it down. I was a complete mess at the time. It’s times like that that patients really rely on their health care professionals, and too often they fail to live up to what is needed.

I’m still a lucky one. I have insurance and can actually go to a psychiatrist and get help, there are countless others out there who can’t. We often tell people to reach out when they are in pain, but if they can’t pay for help, they are simply turned away. This country treats their citizens like garbage. If it’s unsightly, throw it away.

Please support mental health facilities who treat those who can’t afford care, there are so many people who are homeless because they have no where to go for treatment. Take time to be kind.

Have you tried GeneSight? Would you if you haven’t? Do you think it’s beneficial?

I do think it’s a great place to start. It’s telling me if certain drugs metabolize faster or slower than they should, and well all kinds of things. Be sure to read more at their website if your interested.

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Crisis over the Holidays

Oh no!  What a time for a medication mess up!

I was loading up my pill-box for the week and only had 3 of my mood stabilizer…..hmmm, that’s not right?

So, I asked Stuart if there was a refill that hadn’t made it in my case.  (I have a case where I keep all of my medications, then I load up my pill organizer every week, if there are not enough pills in the bottle to fill the organizer the next week then we order a refill….easy, peasy….medication is always kept up to date.)   Stuart didn’t have any refills for me….uh oh.  He said he’d look into it.

We are not using a mail order pharmacy.  A new thing with our new insurance.  If you have a prescription that is maintenance you have to get it from the mail order pharmacy.  So, he goes on-line and it’s right there, with refills so he orders it, should be here within 2 days, no problem.  Great!

Big Problem.  7 days later I realized the medication hadn’t come.  How did I realize this?  I was crying uncontrollably for no reason and let’s just say my moods were going crazy.  My head hurt so much I thought I was going have to go to the ER.  What was wrong with me???  Wait?  “Stuart?  Did my medication come in?”,  “No?” That means I hadn’t been taking my mood stabilizer for 4 days.  Rut Row!!ICONATOR_4e0b548ea7c2830faf155644ee69298f

Stuart calls the pharmacy.  Yes, the prescription had refills, 3 to be precise, but it was written as 3 one month prescriptions.  They needed it to be one prescription for 3 months.  So they had a call in to the doctor to change it.  Oh my gosh!  Did they think to call the patient to see if they needed the medication sooner than they would be able to get it to me by doing things this way?  NO!  Stuart told them that I needed the medication NOW, so they put ONE month worth in the mail and I got it the next day, that meant I was off of my mood stabilizer for FIVE days!

This is not a drug you just go cold turkey on.  You don’t just stop taking it and not notice.  There is reason you ramp up and off of these kind of drugs.  Of course, this had to happen just a few days before Christmas…..as in, I got my new pills on Christmas Eve.  Can you imagine the hell I have been going through?  How have I managed this without going absolutely crazy?  Well, I am crazy we know this…..hehehe  (yes that is one way I deal with things like this….I try to keep a sense of humor…sometimes it works.)   First, I knew how I felt was all because of this medication mess up.  My feelings were not me.  What was going on in my head was not me.  Yes, this is very hard.  I am lucky that I have a good friend who understands a lot of this and I emailed her a lot and she was wonderful.  I’m also lucky that my husband listens and doesn’t get mad when I’m very unreasonable at times like this, he understands it is the medication.  Yes, sometimes he does forget then we both look at each other and take a deep breath and say…..things will be better when the medication gets ramped back up.

Oh yes, that’s another thing, I have to ramp back up on this medication.  I couldn’t just jump back on at the dose I was taking, I could have gotten very sick.  So still, I’m not quite the Wendy I usually am.  I won’t be for another week an a half.  You have to ramp up on this medication slowly or you can get a very bad rash that is not a good thing.

little Wendy at Chirstmas.
little Wendy at Chirstmas.

I’m also dealing with this by trying to be mindful….yep there’s that word again.  I’m trying to just focus on this moment.  That has been VERY hard to do.  I have gotten all caught up in the Holiday Hype, in my mind.  Everywhere I looked people are telling you that you are supposed to be spending time with family and friends.  Really, does the TV not make you feel like something is wrong with you if you don’t have a big family and a whole lot of friends to spend the holidays with?   Oh I got so depressed.  My family?  Well let’s just say, I am so not a part of all of that now, but my mind goes to Christmases past when at times like these.  Now that my medication is starting to work I’m just fine with how things are, I think it’s a good thing.  But when it was all going on I was hurt, and sad and just feeling like my life was so not what it should be.  We have no friends here so we were all alone, and I was thinking about how we were cheated out of not having children and well just everything……see where my mind can go when medication is not working???

Deep Breath here huh?

The past is the past.

I can’t change those things.

The only thing I have any control over is today.

Breathe.   Just Breathe.

and this is how I live my life most of the time.

This is how I see things most of the time.

This is why I stay on my medication!   *wouldn’t you?*

 

I have some good news!!

I’ve been off of the steroids for a good bit now and no bad vertigo!  Yay!!  I’m so thrilled!  I have to say, I was a bit scared.  I tried not to be, but I it was there….fear that the vertigo would start right back up as soon as the steroids came out of my system.   So glad the fear was unfounded….see why we should live in the now and not try to predict the future?

I have started Aqua-therapy for my back/hip and I did great in the pool.  The physical therapy in the pool is so much easier.  I am really hoping it will help.  I see the back doctor next week, we’ll see what he has to say.  I have been very discouraged about my progress so far, but after just 2 sessions in the pool, I’m hopeful this will help.   yay!!

Good news is, in just a short time, I’ll be starting the New Year all stable again.
I haven’t had a full-blown vertigo attack in a couple of weeks.
The aqua-therapy is going well,
and I’m going to making some plans to change a few things around here……so Picnic with Ants is going to have changes….they will happen slowly I’m sure as I’m not able to do things very fast….but we’ll see how it goes.

 

Here’s to a New Year!

May we all great it with love, laughter, and much good luck!

 

Tomorrow is my mother’s birthday.

I will be celebrating her life.

I’m very thankful for the 64 years she spent with us on this earth, especially the almost 30 she spent with me.

Christeen....my mom
Christeen….my mom