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On prozac, trazadone and clonazepam. Suffer from eating disorder. Use laxatives for constipation. Suggestions?

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Practicing since : 2004
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I have been on a cocktail of meds for many years. I almost feel that there are none out there that I haven't been on. About 6 yrs. ago my Dr. put me on wellbutrin 300 mg Xl. It was like a wonder drug for energy but did not last long. I had also been on Prozac for about 15yrs. ago, trazadone for sleep, clonazepam to calm me down, along with many others. I am off the Prozac, at my request as I felt it wasn't doing a thing for me. I suffer from a severe eating disorder, since I was 13, I'm 59 now, last hospitalization a year ago for 12 weeks. I am maintaining my weight, but want to get below triple numbers. I think of suicide often, engage in self harm, do not binge but purge, and use laxatives because of severe constipation - usually about 10 days. I was in the hospital about three weeks ago for 5 days. I now have new doctor, mainly because this one is in town, and I can participate in out patient groups. I was driving 45 miles to see my other for 19 years. I want desperately to end my life, but keep running out of the guts. I am always banging my head against hard objects like cement floors, toilet bowls and steel pipes. I have had a couple of concussions. Burning gives me my biggest thrill. I went and saw my new doctor, we talked. I cried mostly but he did make me smile a couple of times. I want more than ever to be gone from this earth. I do mot see my doctor until the end of Sept.. What do I do. I am so depressed, self loathing and spend my time in the hous.
Posted Fri, 9 Aug 2013 in Eating Disorders
Answered by Dr. Ashish Mittal 10 hours later
Thanks for your query.
I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     59 year old female
•     Known case of known case of eating disorder and severe depression.
•     Complaints of: severe depressive symptoms.

You case is chronic and difficult too. Even your attending physician is facing problem to solve it. I will try to give my best effort to help you in this problem.

As your case is chronic and you already received multiple psychotropic medicines, then your current treatment should based on following information for better benefit:
-Duration of past treatment.
-Type of medicine, doses and duration of use.
-Effect and side effects of medicine
-Medical co morbidities.
-Presence of substance use (if any).

Considering severity of depressive symptoms and self harm tendency, it is better to see your psychiatrist as soon as possible. As you are having severe depression, you can think for admission psychiatric nursing home/hospital for short duration. I can understand your suffering, but there is no short course to relieve it. Your case need detailed evaluation.

Apart from that psychotropic medicines are prescription medicines. If you are having difficulty in seeing psychiatrist, then you should continue wellbutrin as advised by them. If you was better on prozac (compare to current condition) then there is no harm taking it with wellbutrin, as both of them synergistic action when used together. But take it after your psychiatrist consent.

Apart from above advice following simple measures will help you:
-Daily morning walk
-Breathing exercise, yoga and meditation (which you can learn from some expert in person)
-Starting non drug treatment like cognitive behaviour therapy (form of psychotherapy) with medical treatment, which will help in rapid recovery.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
Above answer was peer-reviewed by
Follow-up: On prozac, trazadone and clonazepam. Suffer from eating disorder. Use laxatives for constipation. Suggestions? 9 hours later
I have been on tecta twice a day for reflux. Drug used for reflux, because after eating and then waiting a while after taking tecta I take Prozac. I have terrible reflux of the Prozac almost immediately after injesting it. The burning is sickening and painful. That is why is was removed from it. As for being admitted to hospital, one must remember, this is Canada. You go to a hospital if your life is in danger, anything else they will see you, then turn you away. I was in the hospital about a month ago for causing self bodily harm. That was for 5 days. I was discharged. I was supposed to be seen in a week, but his receptionist made It for over two weeks. During my appointment the psychiatrist talked back and forth to me, then told me I was fine and he would see me in two months. I did my best to keep my crying non apparent until I got out of his office. It just seemed so long away and I was just so sad. I come home, and since then besides hurting myself, I self medicate to make myself sleep. Also you suggested taking walks. Interesting you should say that. I always took walks, personal trainer and all. I have been on cortisone injection for three years, because it cause bursitis. They are contemplating surgery that has not got a very good success rate, but my husband is insisting on it. I do walk until I just feel it starting to hurt, then turn around and can barely make it home at the end of a trip. We live in a 4 level house and my husband refuses to move. My doctor that I am seeing is new. My other one I had for 19 years. He has an appointment set up for me to se if I would qualify for any groups offered in my small city. I go next week for an interview to see. Behavioral Cognitive Therapy is one of them.
I talked to my doctors receptionist about something making me sick, which appeared to be the Wellbutrin and she said she would get back to me if he has anything to tell me. Well I guess he had nothing to say. So I have a 50 calorie piece of toast, after I have taking my Tecta, wait about 30 minutes and every thing comes up. I wish I could have a closer relationship established with my doctor. I can not go back to my other. He was good, but I told him such secrets, liked being raped, my inability to have sexual inter course due to lichen sclerosis et atrophicus, that I feel like I have been totally undressed in front of him. I cannot believe I revealed all these things to him. Finally he made a "You are just going to have to forget about the painful disease, and what the rapes have done to me traumatically." I so admired him as a doctor, that he really let me down after the comment. I ended up in hospital immediately after, once again because of self harm. The said I had a concussion. Is two months a long time in between visits according to your standards. What about lack of communication. I am going away for a few days, and he writes me out 14 day prescriptions. I will run out while I am out of town and will not be able to get it filled prior. This is the first time this has been set up this way. I know I won't, but feel like jumping out in front of a train.
Answered by Dr. Ashish Mittal 19 hours later
Hello again,
Thanks for follow up.

Prozac associated with increase acidity. In that case it is given in low doses (10-20mg) and doses are increased slowly later on.

If a person have self harm tendency, than it is indication for admission in any country, so check for it in your surrounding. If you are getting psychiatrist appointment late, in that case you can be in regular touch with nearby psychologist or counselors. It is good you are joining Cognitive Behavioral Therapy group.

It is better always share your history and trauma with current therapist, as it will provide you relief by ventilation of problem.

In my opinion, considering severity of depression you should have appointment with psychiatrist and psychologist, at least 2 times a month.

Wish you good health.
Above answer was peer-reviewed by
Follow-up: On prozac, trazadone and clonazepam. Suffer from eating disorder. Use laxatives for constipation. Suggestions? 3 hours later
My husband just realized that he has added to his plan at work, the ability to utilize different professions on a short time basis, ie: doctors, counsellors, lawyers, financial planning etc.. I called up and they put me in touch with a counsellor to hope hold me over until I can get into something more definite. I am seeing her tomorrow, although I requested a man - they asked. I to agree that hospitalization may be good along with more frequent visits to my doctor, but that just isn't going to happen. Although people brag about our health system, and in many ways I feel very blessed to have it, we have absolutely no say in our care, the waiting lists are long and lengthy, and if you were to feel you needed a certain test, doctors hold the key. My mother begged for an MRI and after a year of me hounding they found lung cancer and pancreatic cancer. Being part of the medical profession myself, I knew things were not right. Unfortunately they feel the pancreatic ca. were mets. from the lungs.

As for making a suggestion to go back on Prozac, I must admit that I am extremely nervous of it. Dr.'s here do not like being told or suggested things. My last dose of Prozac was 100mg. and me being barely over 100 pounds I was worried it was too much.

I really think your suggestions are right on, but do not know how to move forward. My self harm and suicidal thoughts are stronger than ever. I am crying all the time. Although I do not have an appointment until sometime in September, between now and then I am at lost for what to do. As seeing the lady for an interview for BCT I was warned there is a lengthy waiting list into the different programs.
I thought I had still an other answer coming, and one more question. Is their a reason I don't. You have been so helpful.
I think this is my last question. I have found a lovely counsellor that I met with today. This is through my husband's work. After six weeks one has to start paying, but I think we can handle the fee. She reduced it to $60.00 a session. I will still need my doctor for meds.. Is that o.k.? Am I doing the right thing? I have still got my appointment next week regard BCT? Am I getting into too much of this. I have never had a female counsellor before. The bring up memories of my mother, beating me, making me sleep out doors in below freezing temperature, burning me and trying to kill me. I also had to have a knife beside my bed, because she said she was going to come up some unknown night and gut me like a fish. I was some what a bit on the heavy side, and I was also warned every night, to sleep with one eye open as she was going to come up and shave the fat off me. I spent many nights, sleeping outside, or sleeping in my closet with my dog, who he to, she was going to slaughter. Women stir up these feelings in me. They promised me a man for these session. She is very nice and I was able to relate to her. Should I continue with her. I was wondering if facing a women, might help me get more out than I had expected. Thank-you for all your helpful information.
Answered by Dr. Ashish Mittal 40 hours later
Hello again,

It is true that medicine system can not be changed easily. Every doctor has their own treatment style according to their learning and experience. Same time we should focus, what is the best we can do for us, with available resources.

Starting CBT is very good step, taken by you. Do not worry about sex of counselor. It will not affect treatment outcome. It is good that you can relate with her and comfortable too.

You need to continue appointment with your psychiatrist also for medicinal treatment.

Please accept my answer in case there are no further queries and recommend our services to your friends too if you have found it helpful.

Wish you good health.
Above answer was peer-reviewed by
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