Reached a medication ceiling so what can I do now?

[gertrudetrain]

I was been stable on fluoexetine 60mcg for 18 months. Diagnosed with clinical depression and PTSD. My psychiatrist was very happy that I'd been this stable for a sustained period of time as over the past decade I've had numerous relapse, inpatient treatment, CBT, various meds.

Unfortunately I've felt a shift it feels less and less like I can cope. I've persisted for the last 4 months but it hasn't been modified by lifestyle changes eg exercise, diet, sleep etc. I'm feeling a little overwhelmed. Any ideas what will happen next as i'm on the Max dose for fluoxetine. I'm very scared that the next line treatment might be section/invasive and don't think DH and my 3dc's could survive it. Sorry.

Sorry 60mg that's meant to say for dosage, not MCG.

They might try adding another anti-depressant, it's worth asking. Why do you think you might get sectioned? You have to be at risk to self or others, and they try to avoid admitting people unless absolutely necessary.

The last time I was sectioned (this is a while ago) my mental health act assessment came in quite high risk. I have attempted suicide quite a few times and 2 of the attempts required quite intensive medical intervention on an acute medical ward and then sectioning. I suppose I always stress about my history and feel it counts against me IYSWIM.

Even though it was over a decade ago that my main episodes and I was heavily self medicating I worry that they won't listen and will think I'm regressing to that point and intervene.

As for meds, I've been on so many and fluoxetine was by far the most stabilising. I wonder if they will try me on a higher dose as I've read that they will up to 80mg in some cases?

Sorry 2 year old DD keeps pulling my phone away, hence typos.

You're right that psychiatrists can prescribe higher amounts of meds, so that might be worth an ask. I think as long as you're honest with them, it helps as you're seen to be engaging, IYSWIM.

Think I'll see my psychiatrist before Christmas and ask if it can go up. It has always been at 60mg so it isn't like we've seen it progress from a lower dose to Max. Thanks snowy, even though I know it in my head it helps to have a dialogue about it so I don't feel such a strange one.

I think that the difference over the last 18 months has been because I've been engaging and stopped self medicating. I'm hopeful that they see me as having turned a corner in terms of risk because of it.

It will always be a worry but perhaps I need to see I'm catastrophising because of the depression. The PTSD has made me so cautious of taking things for granted though.

I agree, it helps to voice things. I've just agreed to take a 2nd antidepressant, voicing it on here helped me decide.

Do you feel more anxious or depressed although one usual follows the other!

Your psych may take you up to 80mg or may add something else in
It's not unusual to be on two.

I am very med sensitive I was on cipralex but two years ago went through depression/anxiety yet again so after a few weeks when I didn't pick up was switch over to venlafaxine I was petrified to say the least!

It's taken me 2 years to get where I am now, my depression as gone but I've still got anxiety bad/better days. My psych suggested pregablin for anxiety totally up to me, I said I would try but so scared of start up effects again. Part of me wants to part of me well a lot of me says just a diazepam when needed.

Don't let it get to bad before you go as it will be harder to get back on track and you have young child to take care of.

Thanks everyone. Went to Dr today and they've increased to 80mg but also got to see an acute mh team at 10am on Monday because last night I was hearing whispers that weren't there I don't know if its depression or insomnia causing it. We'll see.

Good luck for Monday