Saturday, March 10, 2018

Medication interactions

Apparently estrogen can decrease the amount of lamotrigine in the bloodstream.  Lamotrigine is the linchpin of my bipolar treatment.  Lithium does this happy little dance to clear away the clouds, and diazepam runs to the rescue when my anxiety gets bad.  But without lamotrigine, everything collapses.

So, goodbye birth control.

I started it up again about six weeks ago and have felt increasingly worse.  At first, I thought it was normal aberration, maybe seasonal.  But the past week, the bipolar cycling has become obvious.  The only times I've cycled like this while on my current med combo are under extreme stress.  The cycling doesn't start up because it's February, and it doesn't start up because I am worried about a medical procedure.

I called the psychiatrist on call today to confirm that the birth control could be the problem.  Why my gynecologist didn't bring it up, I have no idea.  Maybe it isn't on his radar.  Maybe they are more worried about which medications can interfere with birth control and cause babies instead of what birth control can do to people who are on medications for bipolar disorder or epilepsy.

I really hate everything right now, especially myself, and I'm trying to remember that this is a mental state, not the truth.  Just get through today, get through the next few days, and the lamotrigine will be at the proper level soon.  If I'm not too far down the path of bipolar episode, I should come out of this without having to change my medications further.

Thankfully, I was just on birth control for birth control, and there are options that don't involve estrogen.

Pelvic pain data: the birth control I was taking (levonorgestrel and ethinyl estradiol... no brand name provided on this packaging, though there are many) didn't cause me more pain, but it did cause me to pee more.  That was my experience when I was on it before, too.  That time, I didn't note changes in my mood, but it's also possible I was in a rocky place at that point and wouldn't have been able to note changes anyway.

So, of course, when I started Vesicare, intended to treat urinary urgency and frequency, at the same time I started birth control... that was poor science.

Now to figure out how to be okay with the minutes I am in.

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