Posted by Janelle on March 30, 2002, at 15:57:23
Fachad,
Armed with the print-out of your "Meds" post (it was one of those three responses to me which you manipulated in the order of their importance), I went into to my latest pdoc appointment and literally read to her what you had written as follows: (I'm going to divide it into two parts here with her response to each part separately, but in her office I read both parts one right after the other and then she responded).
She was VERY IMPRESSED with what you said and how you said it, and wanted to know who this person was who gave me this info!
Part I: ZYPREXA: You wrote - "As to your Zyprexa, I'm probably overcautious, but I wouldn't take an AP unless I was psychotic. Maybe you could take Remeron instead of Zyprexa at night to quiet your mind and help you sleep. Also, I've heard that Remeron + Effexor is an especially potent AD combination. Maybe that combo is just what you need"
Her response: she reminded me that even though I was NOT psychotic, when she first prescribed the Zyprexa it was because I was having feelings of "not really being here" (depersonalization), feeling out of my body. For example, I thought that I was not able to *feel* the water in the shower, like it was not really there getting me wet. Also, I was afraid and unable to do basic things, like scramble an egg because I wasn't sure it was really getting cooked, couldn't wash dishes because I wasn't sure I was rinsing all the soap off. My sister observed that it was like the perception (watching the egg indeed get cooked, seeing the dishes get clean) was not reaching my brain to make the connection that the task had been completed successfully.
I was painfully aware that what there was something very off about my thoughts, I knew there was something wrong with how detached and out of reality I was feeling (a person who's psychotic does not have this awareness). The Zyprexa took care of all that, and since I am still not stabilized she wants me to remain on it for awhile longer.
As for Remeron + Effexor, pdoc said something to the effect that taking to AD's together can sometimes be too activating and didn't feel this would be appropriate for me (especially since I'm very high strung, with extremely high anxiety, agitation, etc.)
Part II: KLONOPIN: you wrote - "I know it is important not to abruptly stop taking Klonapin. But it may be in your long-term interest to taper off and discontinue it. The reason I think it might be a good idea is taking a benzo long term, esp. Klonapin, can cause depression or make depression worse. It can also cause cognitive impairment and cloudy thinking, which you have complained of having."
Pdoc nodded in agreement with this, but feels that the low dose of Klonopin I've been on helps me from going off the deep end, and is particularly effective when I'm so anxious I feel like I could jump out of my skin. I pop one of those babies during the rare (thank goodness) episodes of uncontrollable anxiety, and within minutes, I'm calmed down.
Plus, when I was on Paxil/Klonopin for many years, I functioned at a very high level (worked a few part-time jobs, returned to school for new career, etc.) Pdoc thinks it's the cycling and depression which causes cognitive impairment, cloudy thinking, etc., not that the Klonopin is making the depression worse.
So, whaddya think? I thought it was neat that the pdoc was SO impressed with what you had to say, and she wanted to address each subject. Wanted to share this all with you, and thank you again for those wonderful three responses from awhile back.
poster:Janelle
thread:101005
URL: http://www.dr-bob.org/babble/20020327/msgs/101005.html