Wednesday, October 6, 2011, 2am:

Calmer than you are.

Tonight, or this morning, before bed, I will take my last dose of imipramine hcl, which, over four weeks, I tapered from 100mg down to 12.5 or whatever strength really dwells in the epileptic, dartboard-skewered quarter of a pill I cut. For three years it's been a cheap alternative to panic, and, although for whatever reason it no longer works at the level I need it to, and although it made me sluggish, unmemoried, and cholinergically arid, it did help a little to block what needed blocking. So despite turning me into a sedentary half-wit and, basically, a viscous, self-moving brick, and despite failing at its sole task when I most needed it, I'm more than a little afraid to be off it. A partial cure is better than none. (I suppose that, in the event that other options exhaust themselves, I can always crawl back to it, supplicating for a higher dose.)

Tomorrow I'm scheduled to begin treatment with sertraline, an SSRI--imipramine is a tricyclic--and to taper my Lexapro dose by half, which I'm only too happy to do, having for the past three years suspected its impotence. (Everybody's different; most seem to think it a miracle drug.) I'm not looking forward to the transition. Starting a new drug that rewires your brainstuff always hurts. It hurts when it doesn't work for a very long time, until it does, and even then, it still hurts with its side-effects. And it hurts worse when you suffer its company for weeks, and then months, and feel like hell as it burns you from within, scorching your brain white-empty and your guts red-useless, only to find that it doesn't work period. We'll see. But after four weeks of waiting, and another four weeks before that of wobbling, I need something to happen. If this change is for the worse, we cross off one drug and jump to another. If it's for the better, we save my life for another few months or years, or however long it takes me to steady myself from within, where the bell got rung and needs to stop swinging.

Wish me luck. The next few weeks may be very hard for me. Or maybe they won't. Psychopharmacology, it's no science, you know.