The Power of One Pill



Pills.  Ah, pills.  “Pill” is such an innocuous-sounding word, but anyone with bipolar disorder who takes medication knows that pills are anything but harmless.  However, unless you depend on medications to keep you stable, and unless you’ve experienced a med horror story, it’s hard to understand why someone highly sensitive to meds would TOTALLY freak out at missing just one dose.

(***Trigger Alert: suicidal ideation***)

Over the past year I’ve become used to taking my MAOI med Parnate (tranylcypromine) three times a day.  That hasn’t been a big deal – I’m incredibly grateful for it since this drug brought me out of bipolar depression when twenty other meds did not.

But as ridiculous as this may sound, refilling my Parnate has been problematic. Here’s a little backstory…please forgive me for it being tedious!  It’s difficult for me to spice up the topic of medication!

When I first started taking Parnate, my psychiatrist wasn’t willing to arrange refills.  His rationale, which he explained to me rather apologetically, was that he wanted to keep close tabs on me.  While I was frustrated with his philosophy (and I told him so!) I understood where he was coming from.  Eventually I asked him to arrange refills and he complied with my request, which was great.

Last week I noticed my bottle of Parnate was getting on the low side and I called Costco to refill it. (Unfortunately, I didn’t think to ask if their pharmacy offers an “auto-refill notification” system so I could be contacted when my medication was ready.  CVS has an auto-refill system that I use with my lithium, and it’s awesome.) In any case, I thought I would be able to get my Parnate without missing a dose.

I forgot that a holiday was coming up, Memorial Day, and that the Costco pharmacy would be closed exactly when I needed to pick up my medication.  That meant that I was going to miss at least one dose, which sent me into a panic.  I was furious with myself because it was my fault for what happened!  Furthermore, I was also mad because I hadn’t thought to ask my doctor if he could prescribe me a few extra “emergency pills” in case this kind of situation happened.  (BIG DUH!)

My husband Craig was in the same room when I flipped out about my error.  We’ve been together for sixteen years and this poor man stood by my side after I was diagnosed with bipolar disorder.  He has been to hell and back in helping me with all my emergencies, care taking, my seven hospitalizations, you name it.

As I threw my tizzy fit, he casually said, “Don’t worry about it.”

What?” I screeched, just shy of a yell since the kids were outside.

Then I angrily muttered,”You’d probably feel differently about it if you were hospitalized seven times in the nuthouse!”

I could sense the hairs on his arms raise in aggravation.  He said nothing and walked away.

At that point I knew I needed to calm down, so I tried thinking rational, soothing thoughts such as:

“You won’t go off the deep end just for missing a dose!” and:

“It’ll all work out!” and even:

“Let go and let God!”

Lo and behold, my mood actually started to level out.  I released my anxious fears because there was absolutely nothing I could do short of robbing Costco.

I felt contrite for blowing up at Craig, and I tracked him down.  I told him I was sorry; luckily he accepted my apology and gave me a hug.  I know he’s burned out from having heard about my medication woes for so many years.  Anyone, even Mother Theresa or the Dalai Lama, would be tired from my numerous complaints, emergencies, and years of seemingly never-ending depression.

While I blame myself for not creating a good medication refill system, I do give myself a break regarding my feelings about missing doses.  I give myself another break for how powerful a pill can affect my system.  The following tale is why I’m letting myself off the hook for my tantrum one last time.

One, itsy, bitsy psychiatric pill made me suicidal.

My former psychiatrist prescribed me an antidepressant medication called Elavil (amitriptyline) and after I filled the script, I took my first pill. Literally two hours later I wanted to hang myself with my bathrobe belt and Craig, thank God, was home.

I told him I felt suicidal and he rushed me to the hospital. There is no way that anything else but that pill that made me feel that way.  I know the subject is so morbid to think about, but up to that very afternoon I knew that if I would ever actually take my own life, I would *never* use that horrific method.  I think that my brain played tricks on me, triggered by the medication, because someone I had cared about had hung himself just a month before that awful day.  I suspect my brain synapses wanted to do a copycat action in reaction to the medication. Who knows? Again, thank God Craig was home.

Because of what happened with Elavil, I’ll never underestimate the potential consequences of missing a single pill or taking a single pill.  I’m paranoid, yes, but now don’t you understand why I feel that way?

So there you have it.  “What’s the point of this post?” you may be thinking.  (I know that’s what I would think!) Well, if you have bipolar disorder and take medication, I implore you, don’t wind up like me.  See if you can arrange an auto-refill system with your pharmacist.  I know CVS does it and I’m going to call Costco to see if they offer the same program.  I’m also going to check in with Dr. D. about having an emergency supply of Parnate – at least a few days worth.  I’ve been wisely advised in this comment section by Rob to buy a weekly pill dispenser to give me more notice when I’m getting low on meds. (Thanks Rob!)

I do make a point of carrying an extra dose of Parnate in my purse in case I find myself away from the house unexpectedly for a chunk of time. These are all little things that can make such a big difference in my peace of mind, and yours.  Take care and may all your script refills go as smooth as silk! 😉


imgrescat pills(Hope this cat photo doesn’t offend you – I thought the expression was hilarious!!) 😉


19 thoughts on “The Power of One Pill

  1. Dear Dyane
    Hun hope you r feeling well. Plz always remember we love ya and r there for u.
    I can imagine how scary it is to miss a dose. I use Walgreens, they have an app which remind you a week before the refill is due. all u gotta do is click on your cell n u r done.
    I hope sincerely that u r doing well. M sending you my prayers.

    • I know you’re there for me, sweet Zeph! That’s cool that Walgreens has an app. Unfortunately, I have what I call a “dumb” phone from the old days. But I think that if I get set up for auto-refill phone calls (if Costco does it) and a pill dispenser *and* a few extra pills on hand, I’ll be okay. Keep me in your prayers for all of that! Love ya!

  2. I know your feeling on this one. I finally had to resort to one of those 7 day type pill planner holders, too many meds to keep track of. The nice thing about it is I fill it up for the coming week and it usually servers to give me notice a decent amount ahead of time. Medicine is scary stuff. Even if it doesn’t take you quite to that level it can do mean things. My first introduction was when my family doctor put me on Lexapro and no mood stabilizer. I though me into such a horrific rapid cycling, I would cycle several times a day. It was madness. Even today, if I miss just on dose of Effexor, I end up with the “brain shivers” and other discontinuation symptoms associated with SNRI’s.

    • Rob, thank you SO much for your comment! I edited the post to include your suggestion at the end. :)) Great suggestion to get one of those 7-day dispensers – I’ll do it now! Sorry you too have a med horror story. I hope you never miss a dose of Effexor!!!!!! Take care, thanks for reading, and have a wonderful day!

      • Missing a dose of Effexor is the leading cause of taking sick days for me. I get a fever, nausea & vomiting, a migraine, and I fall over with dizzy spells.
        Lithium made lose my grip on jar lids and I couldn’t navigate a straight line walking across a room.

        Tricyclics made me angry and seroquel made me gain sixty pounds, halted my dreams, gave me nerve pains and muscular spasms. None of which have gone away after a year and a half of not taking it.

        Better living through chemistry!

        Seriously though, we play a tense game with our meds. Can’t live without them, but side effects and missed doses Really kick us around.

      • Wow – all those nasty effects you endured sound atrocious.

        Seroquel is powerful, no doubt about it. It helped me sleep again, but the side effects are there: grogginess & some weight gain and wackadoodle dreams. I have a tummy now that I call my “Seroquel belly” – I haven’t gained a ton of weight, but most of the pounds I’ve put on have gravitated to my stomach. It’s really weird and has never happened this way to me before except for pregnancy, which was no problem!!!!

        Seroquel is mysterious, that’s for sure. I am so sorry that you still have awful-sounding side effects for a year and a half after taking it. :((( For want of a better word, yuck!

        So yeah, I have a love/loathe relationship with my meds….mostly love these days, but of course I wish I never had to ingest a single pill. I wish you well and thanks for reading and for the empathy!

  3. I can relate times one thousand. I have to refill my damn Clozaril script every WEEK because I have to have a blood draw every week to make sure the Clozaril isn’t killing me 😉 It is majorly frustrating because the lab is supposed to automatically fax the results to Walgreens, otherwise they won’t refill. The lab gets it right about half the time. The other half, I have to call, Walgreens has to call, I have to wait, and I stress that I won’t get the medication in time for my next dose. I am completely fed up with this shit!! I am going to talk to Dr. BigHeart today and DEMAND a replacement for the Clozaril. I can’t do this anymore!!

    Sorry for the rant….but you know how it is! 😀

    • Rant anytime, my dear! Wow – that’s quite a workout! Good for you for wanting to figure out a way better alternative with Dr. BigHeart – I mean, just the things you need to do to take Clozaril would make someone nuts, ya know!????? You don’t need that crap every week. Life is hard enough! Love & (((hugs))) and thanks a zillion for reading!

  4. Dyane, I can totally relate. I am medication sensitive, too. Twenty years ago I had a negative experience with Norpramin, another tricyclic, that lead to full-blown psychotic mania. Even a single missed dose can throw me for a loop. I have begun to be less reactionary about screwing up with my meds, understanding that I will be off kilter but can make it through. I just changed my morning medication dispenser to a freebie the International Bipolar Foundation gave out at a conference at Saddleback Church on Mental Health and the Church. Now my two containers (one for AM, the other PM) look significantly different, so I’m less likely to take the wrong meds.

    • I wish I asked you to get me a freebie and send it on up, Kitt! 😉 You truly understand. That’s so good that you are less reactionary now about med mix-ups. It’s the healthiest way to be, really. I mean, we aren’t going to combust, right? At least with the non-tricyclics! I am paranoid by nature, but in writing about my thoughts & experiences (and reading comments) I feel better in general. That’s smart, by the way, to have two different looking containers for AM & PM!!! Thanks for reading, liking, and commenting…I value it all.

  5. I learned, too, to keep extras on hand because I used to panic at the thought of running out of mine. I’m lucky to be able to get 90 days worth through medicare/disability now. I fill up 8 1-week dispensers, 4 for am, 4 for pm, so I can plan well in advance for refills.

    Bipolaronfire: A week at a time? That would drive me up a wall. Don’t blame you at all for wanting to change scrips.

    BTW, Dyane, love that blue and white capsule. Thanks for the laugh.

    • Hi Susan!

      Thanks *so* much for reading this post and for the follow! I am happy you got a kick out of the blue & white capsule image. There were so many other ones I wanted to use that were equally funny – I always love looking for images to accompany my posts.

      You are very, very wise to keep extra pills and you are quite fortunate to get the 90 days worth of pills at a time, as you already know. Your wonderful organization is motivating me to get my act together sooner rather than later. I’ll be sure to check out your blog, and once again thank you for checking out my blog. I hope you have a lovely weekend!!!

      take care, Dyane

  6. I understand so, so much! I am terrified by the thought of running out of my mood stabilizer Zyprexa. Without it I am unable to sleep. At all. I stay awake all night itching and if I do start to fall asleep my twitching muscles or spasms wake me up again! It is hard to believe missing one little pill can do that. I am hopelessly dependent on certain drugs, without which my life would be hell. Great post! That is a subject I have not heard talked about much. Glad you did! 🙂

    • I hope with all my heart, lehendersonauthor, that you NEVER run out of Zyprexa! You lifted my spirits by letting me know that you haven’t heard this subject discussed that much, because I know “you’re in the know” more than most. Thanks for stopping by and thanks for reading/commenting. It means a lot to me!

  7. Hi,
    Have just been reading some of your posts, old and new. So, lithium worked again after your crash? And you take Parnate and Seroquel for sleep? I notice you said you were med resistant for a long time. What changed this? ECT? How many bilaterals did you have in 2013? Were they spaced every 2 days and how often was maintenance? Did your memories return after the 6 months or did you have gaps? Sorry for all the questions, but curious what worked since you seem to be doing so much better. Would you have ECT if you felt as bad as you did after ELavil? Did the doctors believe you when you said you had a one pill reaction?

    • Hi Truth! You are asking very intelligent questions – I’m impressed! 😉 Okay, yes, lithium DEFINITELY worked again after the last relapse and I’m at 900 mg. I started slipping last year when I got down to around 450 mg of lithium…not sure if I already wrote this somewhere. I do take Parnate for the bipolar depression. (10mg 3x/day for a total of 30 mg – some folks take a lot more) Seroquel solved the hell-on-Earth agitated insomnia problem & I’m at 100 mg right now; hoping to taper down to 50 mg just so it’s easier on my body…the ECT brought me out of acute suicidal ideation twice. Unfortunately, I didn’t keep track of how many bilateral ECT’s I had in 2013, but it was definitely for less than a few months and I’d like to say I had less than 15 total. I first had them done as an impatient and then as an outpatient. I’m going to get my records for the purpose of my book and it’s just good for me to know anyway. I wish I could answer you on that right now!

      Re: your med resistant question, without a doubt it was the Parnate added to my lithium. ECT was for acute suicidal depression.

      My memories have returned after 6 months (I only had short-term memory loss and not long-term) and there were no gaps, thank God. I know I am lucky.

      I * think* my former psychiatrist believed me about the one-pill reaction but I can’t prove it. My current pdoc does believe me.

      I would ***definitely*** have ECT done if I ever feel as bad as what happened with Elavil. I’d ask for that in a heartbeat. I haven’t felt the need for maintenance ECT as the Parnate/lithium combo. did their job so well, and continue to do so. (fingers crossed that keeps happening!)

      Please don’t hesitate asking me any follow-up questions! If I can help you in any way, I’d be honored and thrilled. I’m in a rush to go pick up my girls at school so if there are typos/syntax/logical errors please forgive me and let me know if you need clarification!

      take care,
      Dyane 🙂

      • P.S. parnate is actually an old school MAOI antidepressant which I took for bipolar depression…it had nothing to do with sleep

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