Over the years, I learned there are different types of antidepressants.
There are the Tricyclic antidepressants, like Tofranil and Sinequan. Dr Jarasinghe told me that Tofranil was the ‘grandfather’ of antidepressants, and its use as an antidepressant had been discovered by accident. According to Dr Jarasinghe, it was designed and tried for tuberculosis, but in trials it was discovered that it improved mood.
The MAOIs – the Monoamine Oxidase Inhibitors – have lots of dietary restrictions and interactions with other medications. Aurorix is a MAOI, although (when I was on it) it was a very new MAOI, and didn’t have the same restrictions.
Then there were a newer branch, the SSRIs – Selective Serotonin Reuptake Inhibitors. Whereas the Tricyclics just flooded the entire brain to elevate mood and stuff, the SSRIs were much more specific, and thus were (meant to be) more effective.
Dr Jarasinghe prescribed me Aropax, an SSRI meant to be successful in dealing with anxiety, panic attacks, and OCD. Coincidentally, I’d seen an ABC report on it years earlier which had raved about it as a wonder drug for panic attacks and OCD. When I’d seen the report, I’d thought, I wish I’d had that! And now that I was about to, I didn’t want it.
The Aropax came in 20mg tablets, and looked like Panadol gel capsules on steroids. Shortly after taking my first one, my heart raced and chest cramped. Dizziness and light-headedness swamped me. Fifteen minutes later, I was in the toilet as my stomach broke up. The anxiety exploded to a new level and everything around me seemed surreal.
When I took the next Aropax the same thing happened, but worse. This wasn’t right. There was no way any medication was meant to make you feel this bad. I spoke to Dr Jarasinghe, who recommended taking only half the Aropax for several days until my body got used to it, then going back to the full dose of twenty milligrams.
The physical symptoms were mildly less once I did that, but not enough to make a difference. And of the anxiety symptoms which amplified, the worst of them was the intrusive thoughts. All the old fears returned: that I’d hear voices; that I’d lose touch with reality; that the television would talk to me, and the uneasiness around knives. And with the latter, there were new fears. I had an image that I’d grab the knife and slash, clear away, my genitals. I couldn’t shake the thought, and the more I tried, the worse it got.
I spoke to Dr Warren and told him that the Aropax made me feel horrible. I probably didn’t convey how emergency-room-bad it made me feel because Dr Warren suggested if I went off Aropax, it’d be five days before I could move onto something else because there was a danger of serotonin toxicity – a serotonin overdose due to the overlapping of drugs that both affect that part of the brain.
Waiting five days wasn’t a possibility. I was barely surviving. I needed a solution NOW. There was no guarantee I’d have better luck with the next antidepressant either.
The alternative, Dr Warren told me, was to use Xanax to bear me through until the Aropax worked. He said the most he’d heard anybody using was ten milligrams daily, and suggested using two milligrams four times throughout the day: morning, afternoon, evening, and night.
Xanax became the answer. From once using it as sparingly as I had, now I was pushing it to the brink of overdose. I’d wake up in the morning, eat breakfast, and take my first two milligrams of Xanax, then sleep until noon. I’d have lunch, and another two milligrams of Xanax, and back to sleep. At dinner, I’d take another two milligrams, and another two just before I went to bed. There’d still be surges of panic, though. Intrusive thoughts ravaged me. Even asleep, thoughts plagued me with the lucidity of nightmares. I felt as if I’d never emerge from this. I just wanted to close my eyes and not know anything anymore.
Come bedtime, I’d sleep for a couple of hours, but then wake at about 2.00 am and have trouble getting back to sleep. Then I’d awake periodically throughout, always with a mixture of dread and alertness that it was just me, the night, and my scarred consciousness – the very worst company I could have.
The Aropax worked quickly, though. Just over a week later, I’d have bursts of wanting to do things – little things, at least. I’d sit at my computer for half an hour or so and check my email, or play briefly with Wolf. Then I’d have to go back to lying down. But as the Aropax shouldered more and more of the burden, I whittled away the dosage of Xanax and slept less throughout the day.
Still, I struggled with sleep. Dr Jarasinghe conceded that the Aropax might be responsible – that with some people it caused drowsiness, but with others it caused wakefulness. He suggested changing my dose from dinner to breakfast.
It didn’t help.
Also, taking the Aropax in the morning I really noticed the dizziness. Sometimes, it got so severe I had to lie down. I hadn’t noticed it before because of the Xanax and because I’d always been lying down anyway. Gradually, the dizziness lessened, but it never disappeared entirely. My first cigarette for the day flared it until it nearly literally knocked me off my feet. This was something that had never happened in all my years of smoking before going on Aropax, and it had never happened with anything I’d been on prior.
Something else was happening to me.
And the Aropax was responsible.