Posted by JohnX2 on April 2, 2002, at 18:02:00
In reply to Hi John, response and small question here!, posted by Janelle on April 2, 2002, at 17:38:47
> Hi John,
>
> Well, from your lips to G-d's ears when you said that "it sounds like things are moving briskly in the right direction."
>
> Depending on how it plays out with the Depakote, I sure will sure will ask about adding on some Neurontin if I still feel jittery.
>
> And GMTA - funny you should mention the "room to play with the Effexor dose" because for the longest time I was unable to tolerate more than 75mg/day. I'm at 150mg/day and the pdoc DOES intend to reduce it, but she only wants to make one change in the cocktail at a time (e.g., this time adding Depakote) because if we did two things at once (e.g. add Depakote, cut down Effexor dose) we would not know which one was causing what kind of reactions in me! Meaning if we both added Depakote and reduced Effexor and I calmed down nicely, we wouldn't know if it was the Depakote and/or the reduced Effexor!
>Frankly from a medicine prescribing standpoint I think your current pdoc is good. Its too bad that ?her? professional relationship fell apart not returning calls etc. She seems to follow good practice in regards to psychopharmacology.
A good pdoc will only try to change one variable at a time, but you should be able to make a change in between office appointments over the phone if necessary.
> I have heard that Effexor can be quite be quite stimulating, been there done that last year when I had gone to 150 and was bouncing off the walls. She had cut back to 75 back then, but months later had me try once more to raise it again due to depression not lifting. At that second time at 150, I didn't bounce off the walls so I've remained there, but I have a hunch that 150 is playing a role in my inability to get a handle on this anxiety. I think the 150's effects in inducing anxiety are more subtle this time than last.
>
> I'd rather decrease Effexor first, before I add in yet another med (Neurontin). I'm already on 4 things!
>
> My QUESTION for you is - do you think the one cup of coffee I've been having each day could be inducing anxiety, almost counteracting any beneficial calming effects of the Depakote? It's hard to believe cuz I've drank coffee (one cup/day, two at most) for YEARS and YEARS and NO anxiety, jitters or shakes like I get now.
>It seems as though you are experiencing some sort of mixed/agitated/dysphoric hypomania/panic with the racing thoughts and all. In this case caffeine will set you into "overdrive". Caffeine is a convulsive. It does this to me. So yes, cutting it out will help tremendously. You may ask to raise your klonopin dose, but your pdoc may be leary about this (because of dependance). This is where Neurontin is a good substitute. Its usually pretty benign to add on top of Depakote, and is non-addictive. But first see how you do on the Depakote.
> Finally, thanks ever so much for your comment that I'm a "touch person" that you can "see it" -- I feel the FARTHEST thing from tough, I gotta tell you!
>Shit, girl. Anyone who makes it through this crap and deals with flaky doctors and also learns alot and stays in the game has got some guts. You'll come out of this a much stronger person.
> And thanks for indicating that you "know" I will do well. Since you are so bright and intelligent, I will trust your perceptions and try to be optimistic that I am tough and I will do well!
>
> Thanks as always for everything.
> -JanelleI know you will do well because you keep coming back. ;)
John
poster:JohnX2
thread:101511
URL: http://www.dr-bob.org/babble/20020402/msgs/101543.html