I’ve suffered some occasional migraines, ne’er suffered before bipolar, since starting my Effexor XR.  Fortunately, they’re not so bad, pain-wise, compared to other folks I’ve known– they usually resolve with a nap and my meds.  But lately, they’ve been worse, not so much with the pain, but in frequency and in new manifestations– smell sensitivity, dizziness, nausea, hot flashes, generally unbearable wooziness.  I want them to stop, because if they don’t, I’ll have to stop taking the Effexor, and that means another round of trial and error on a new antidepressant, and feeling depressed and anxious in the meantime.  I’m too exhausted right now to start a new trial of meds, and to bring the necessary vigilance to bear.

If it’s a temporary side effect of titrating my new dose, and/or a withdrawal from going up one dose too high, hopefully it’ll go away.  But if this is the trade off for less craziness?  I need to try something else.  I can’t work when I feel like barfing whenever my secretary walks into my office, because her perfume is too smelly that day.  I can’t work when I get a hot flash and the whole room moves in front of me, so badly that it’s noticeable to colleagues (fortunately so far, only those already in the know and on my side).  I can’t work if the smell and taste of food makes me gag, so that I don’t eat anything, and then get low blood sugar.  And I can’t drive home if I am feeling like I am going to pass out, because what if I do?  I couldn’t bear hurting someone.  And I am not ready to give up on work.  Only if I can’t handle the stress of continuing private practice will I give up, and do something less stressful.  But that’s not a tradeoff I am willing to make.  Yet.