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The Pill Diaries: Pristiq + Lithobid + Vyvanse

Our writer emerged from her depression pit and thought, Oh, look, I don’t need meds anymore. Wrong. She spent years mixing and matching to find a stabilizing cocktail.
A bunch of open, empty pill bottles
Haley Lawrence/Unsplash

In the mental health world, a debate persists: to pill or not to pill? For some, prescription meds can be lifesaving; for others, they’re not a preferred treatment method. In “The Pill Diaries,” we’ll be telling your stories in your own words. The goal: End pill shaming, bust stigmas, and promote understanding. After all, each person’s journey to better mental health is uniquely their own. 

“Am I gonna have to take medicine when I’m a grown-up?” My six-year-old niece reaches into my pillbox and hands me one 100 mg tablet of desvenlafaxine (Pristiq, an SNRI antidepressant) after another, and I gulp them down with coffee. 

“Maybe,” I say, holding out my hand for the rest. “Some grown-ups need medicine but some don’t. We’ll have to wait and see.” She drops two 300 mg tablets of lithium carbonate (Lithobid, a mood stabilizer) into my open palm along with a 20 mg tablet of lisdexamfetamine (Vyvanse, a stimulant that stops me from falling asleep in the middle of the day). 

I hope she stays a healthy, fresh-faced little munchkin forever, but I can’t count on it. That’s why I keep my language neutral when I talk to her about the pills I use to keep my depression and anxiety manageable. When I was first prescribed mental health drugs nearly 25 years ago, I was in crisis. My days had devolved into a cycle of crawling in my skin, laying in bed sobbing, and pulling out my own hair in a glassy-eyed trance (a body-focused repetitive behavior called trichotillomania). I would have done anything to make it stop, including trying the pills my psychiatrist prescribed. 

I assumed I’d be on antidepressants for a few weeks, maybe a few months. I never thought I’d still be taking them in middle age. The thing is, it’s not so easy to find a combination that works for you. Sometimes, they don’t do anything at all. Sometimes, the side effects are intolerable. Sometimes, the drug that worked so well for years just poops out on you, and you have to start from square one. 

I’ve tried SSRIs including sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa), and escitalopram (Lexapro); SNRIs including desvenlafaxine (Pristiq) and venlafaxine (Effexor); and tweaked the results with other drugs including bupropion ((Wellbutrin), naltrexone (ReVia), alprazolam (Xanax), clonazepam (Klonopin), lamotrigine (Lamictal), vortioxetine (Trintellix), and lithium (Lithobid). A veritable medicine cabinet of possibilities.

The funny thing is, it’s when the medications are working well that you’re most likely to eff it all up by deciding you don’t need them anymore. Why? Well, because the side effects you overlooked when you were desperately depressed now seem more annoying, medication is expensive AF, and the prevalence of pill-shaming probably means you don’t like the idea of staying on it long-term. Plus, by now, you’ve probably learned some new coping skills you might think are enough.  

I’ve made this mistake twice. (No, I didn’t learn my lesson the first time. The second time, I was heavily into yoga and meditation, which I mistakenly believed could keep me balanced alone.) Both times resulted in brutal recurrences of depression and anxiety that took months to stabilize. If you ever find yourself questioning whether it’s time to go off your meds, consider that the reason you finally feel like yourself again is BECAUSE THE MEDICATION YOU’RE TAKING IS WORKING. 

Look, no one wants to be on medication they don’t need. To be honest, the experience of treating your mental health can be extremely frustrating. Psychiatry isn’t an exact science. The combination of Vyvanse and Pristiq and Lithobid work for me, but there’s no surefire way for your doc to know which drugs will work best for you. Or for how long they’ll work. The only thing I do know? My mental health is more stable on meds than off them. 

And that’s all I really need to know. 

MENTAL NOTE: A medication one person takes may not work for another and may have different side effects. Always talk to your doctor before trying or switching psychiatric medications. The photo on this story is not representative of the actual pills discussed. The views expressed in this story are solely those of the author or source who requested anonymity.

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