Should I ask to change meds?

[Cantspellmynameright]

Hi, I have previously been diagnosed with ongoing depression/anxiety coupled with 2 bouts of PND and as my doctor put it - I just dont make enough happy chemicals myself!

I have been on and off of citalopram since I was 21, usually feeling much better after 6 months or so, weaning off slowly, then dipping and going back on it. My doctor feels a long term plan may be more sensible due to the repeating cycles of medicating then crashing.

I have also gone through several cycles of counselling for childhood issues (divorce/abuse/neglect), and have discussed some of my more OCD behaviours and fears/phobias, but I always end up never quite getting it all out in the limited sessions available (we get 6 sessions on NHS here).

During my last bout of PND I had not been medicated for 10 months and was prescribed Lofepramine as I was determined to breastfeed and did not want to take any meds that would mean I needed to stop. My doctor researched Lofepramine for me and gave me all the info on how it works, reacts, goes with bf'ing etc. I was happy to take it and it has worked well for me since then (20 months ago). I only have a slight sleepyness from it (I take it at night anyway) and it has seemed to be ok till now. The drawback with it is that the dose I am on is half strength and I don't think I'd be able to get up in the morning if I went to full strength.

Recently things have been very, very hard at work, with possible BIG life-altering changes coming up at home (and I'm not the patient sort) and also generally dealing with two very fun and enthusiastic chidren has had me feeling very low again.

I am lucky to have a very good DH who I can talk to and who understands how bad I am at the moment.

I have an appointment to see the doctor next week, but I am wondering whether to ask to go back to the Citalopram now that I am no longer bf'ing. I felt I was more able to alter the dosage acording to what life was throwing at me with the citalopram and that as I took it in the morning I wasn't worried about getting addicted to the drowsy factor.

Is it crazy to ask to come off the Lofepramine and go back onto the citalopram? I think (from what I remember of my pharmacy training) that I'd need to stop the lofepramine for two weeks, then start the citalopram. I think with DH's help I can get through that time.

Sorry for waffling away, I've probably not been very clear. I just need to get my head sorted so I can get out of this fog and back on with life.

Hoping someone can help :)

a curveball, and not what you asked, but is there a chance of having some longer term counselling privately to sort some issues out properly?

Hi madmouse, in all honesty I'd love to be able to get into some long term counselling as I always start knowing it's going to be over soon and I have to prioritise the issues!

Unfortunately, where I live we only have access to the six sessions at a time, then we have to go through the waiting list process again as they are desperately short of appointments so have to ration them. Occasionally they will give longer to some people but only if you are at risk from harming etc. Even then it's usually passed over to the psych teams.

I have looked into private (not NHS) counselling and I just cant afford what they are asking and I'd also have to travel a pretty long way (up to 30 miles) to get there.

such shameful shortsightedness on the side of the NHS to give so little counselling - in the long term it is cheaper than drugs in so many ways

I had 14 sessions with a brilliant psychotherapist on the NHS (she did all the assessments and due to the severety of my symptoms took me on herself) - seems to have been improbably blessed there compared to what others tell me. And after that I had fab counselling from a specialist abuse survivors charity. It did put me back on my feet.

Can I move where you live madmouse? :)

Hi, don't know if this will help. I have had three children and after each have had citalopram, first time worked beautifally and was able to come off after six months. Second time thought I could tough it out but was back weeping in the gp's office. Again it worked well. However, the third time I took it I was on it for much longer, nearly two years and it had a very numbing affect. I decided with my gp's help to come off it as at the moment I feel I can manage. I don't think there is a one size fits all long term plan with post natal depression and it can linger for a long time and mix up with other outside pressures and things that have happened in the past that have not been fully resolved. I think the key thing to help yourself is not be too hard on yourself. Two small children and a job, it's not easy. Also my exprerience is that counselling is impossible to come by on the NHS so you are left with no other option but to carry on or try and find the money for private care. My guess is that you will end up feeling guilty spending the money on a counsellor, if you can afford it don't feel that way. If not, go back and get your six sessions again,

Hi, a quick update (and thanks also to Lovelynewboots for you reply)

I saw my doctor tonight, he's happily changed me over to citalopram, starting tomorrow morning at half dose for a few days to help with the buzzyness I get with it.

He also did the quick questionaire with me and I scored 18 out of 21 on the anxiety. I told him I felt the anxiety was the root of the problem - I get anxious, dont sleep, feel crap the next day and therefore really low - and he's agreed I need more counselling to try to get to the root causes and issues and also for help with CBT again.

Feeling awful now with a banging head from talking about it all but glad it's over, I'm not being a wuss and I do need more help (not felt like that from here but in my own mind!)

Also got 'told off' for letting work take advantage and reminded to set some boundaries so I'm not 'on' 24/7.

So all in all a good turn out, just got to wait for a date now....