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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by waterfall on May 11, 2006, at 18:23:51
Hello,
Suggestions for major tranquilizers? Particularly ones you could still do detail-oriented work while taking and maybe add a half mg of Klonpin on occasion without ill effects?
Here's where I'm at:
I Have bip-polar two going on here but it isn't being controlled real well right now. The easiest way to say it is that my head is LOUD - busy with intrusive thoughts and my heart pounds constantly and I feel like I'm on fire most of the time.
Well, enough of me and on to my meds. I was on 300 Seroquel and it was GREAT - made things nice and quiet. My skin wasn't crawling. But I stopped going to the bathroom altogether without water-based assistance. Three weeks later and that's just not so good. Also, the Seroqeul didn't completely quell the anxiety and so I was adding maybe 1/4 - 1/2 mil of Klonopin a night.
But the main problem was that I was making way too many mistakes at work. That is really bad in my position. My work is very visible and the place is full of proof-readers. Plus, of course, I couldn't go the bathroom on Seroquel.
So, I'm off the Seroquel and my head is screaming again and I feel like I'm on fire and my skin is crawling. tomorrow my shrink will try another of the major tranquilizers.
All suggestions greatly appreciated!!
Thanks!
P.S. I also take lamictal, lexapro and just 450 of lithium as a booster.
Posted by blueberry on May 11, 2006, at 18:34:10
In reply to advice on a major tranquilizer, posted by waterfall on May 11, 2006, at 18:23:51
Ideas...
Depakote extended release 500mg, maybe up to 1000mg in a few days. The good thing is that if it is going to work, it will do so anywhere from 1 day to 6 days. Depakote can shut that overamped stuff down fast, usually but not with everyone. It does have some cognitive blunting though, so maybe not good for your job.
Zyprexa 2.5mg to 10mg. Again, if it is going to work it will do so in 1 day to 6 days. Sedation at first can be heavy for some people, it does wear off in a few weeks. But it is not as sedating as seroquel. But it can actually boost cognitive function instead of hurt it.
I had a severe dyphoric mixed mania once, where I had depression mixed with going 1000mph at the same time. It was aweful. Zyprexa worked good but only for about 6 hours. After adding depakote to it, there was peace and calm on the very first day.
Other than that, maybe a different benzo.
Posted by Phillipa on May 11, 2006, at 19:26:37
In reply to Re: advice on a major tranquilizer, posted by blueberry on May 11, 2006, at 18:34:10
Standard answer Valium? Love Phillipa
Posted by Caedmon on May 13, 2006, at 17:34:27
In reply to Re: advice on a major tranquilizer, posted by Phillipa on May 11, 2006, at 19:26:37
Yeah, a valproate such as Depakote might help.
I am partial to risperidone myself among APs. I don't know if it's a good thing for long-term use considering how tightly it binds to dopamine receptors. But it sure clears up my thoughts! :-) Zyprexa is likely to have less problems with EPS or prolactin elevation, but it causes more weight gain. It may be worth a try.
- Chris
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