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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 183 to 207 of 212. Go back in thread:
Posted by qbsbrown on August 12, 2009, at 21:09:36
In reply to Scott; Antihistamines, posted by qbsbrown on August 12, 2009, at 16:40:13
Doxepin and Tegretol don't play very nice together do they? Just checking out the drug interactions.
Brian
Posted by SLS on August 13, 2009, at 5:36:55
In reply to Re: Scott; Antihistamines, posted by qbsbrown on August 12, 2009, at 21:09:36
> Doxepin and Tegretol don't play very nice together do they? Just checking out the drug interactions.
What is the problem?
Where did you find this information? I'd like to take a look at it.
- Scott
Posted by qbsbrown on August 13, 2009, at 9:33:40
In reply to Re: Scott; Antihistamines, posted by SLS on August 13, 2009, at 5:36:55
I just did a search for drug interactions on different websites. Did speak to a pharmacist who said that the tegretol might lower the amount of doxepin.
Would that be like taking 2 tcas?
Would it be risking heart problems? I already had a small minor surgery for an arythmia.
I hate antidepressants, but it/they sure made tapering easier in the past.
I wonder if I could get a way with 25mgs at night.
Regards,
Brian
Posted by qbsbrown on August 13, 2009, at 10:58:44
In reply to Re: Scott; Antihistamines, posted by qbsbrown on August 13, 2009, at 9:33:40
Well, I wonder if adding doxepin might help. Another necisary evil w/ the tegretol. I have to eat, and i have to sleep. I'm waking up at 3am, and i wasn't able to eat before antihistamines.
The tegretol is already taking it normal anticonvulsant brain disabling mechanism in me. Not wanting to shower, to do dishes, the garbage,etc, the things i had finally returned to since quitting the meds. But I know this will be temporary.
Tomorrow, I go in to a detox facility for an assessment (it's required before taking my DUI classes (I drank 1 time in the last year, and got busted for a DUI), as they say coming off the benzos is dangerous, and they want the ok before being able to take their classes), so i'll let you know how that goes and what they say.
Brian
Posted by qbsbrown on August 13, 2009, at 11:40:05
In reply to Re: Scott; Antihistamines, posted by qbsbrown on August 13, 2009, at 10:58:44
Scott, I think I'm gonna take the tegretol to 1000mgs on saturday. That said, if I feel ready to cut a little bit, 1mg, should I go ahead? Or would you say wait til been on 1000mgs for 5 days?
Brian
Posted by qbsbrown on August 13, 2009, at 17:57:21
In reply to Re: Scott; Antihistamines, posted by qbsbrown on August 13, 2009, at 11:40:05
Well at this point, I can continue on on my own route. I'd probably sadly have to add an AD (I might go Doxepin rather than a SSRI) to be able to sleep a little and to be able to eat. I HAVE to be able to eat.
Or, I can fork over serious money and go see an addiction specialist, who probably doesn't know more than i, but it'd be nice to be monitored for any serious physical complications that might arise.
Or lastly, I can go to a detox facility and do it there.
I detoxed in 1 week last summer, returned to the states, but had serious racing thoughts from the quick detox, so i thought that i was bipolar, and started the wheel over again.
I'd appreciate your feedback.
Regards,
Brian
Posted by SLS on August 14, 2009, at 0:30:32
In reply to My options, posted by qbsbrown on August 13, 2009, at 17:57:21
> Well at this point, I can continue on on my own route. I'd probably sadly have to add an AD (I might go Doxepin rather than a SSRI) to be able to sleep a little and to be able to eat. I HAVE to be able to eat.
It sounds like a reasonable plan. Doxepin has survived the test of time in demonstrating efficacy for depression, anxiety, and insomnia. Being an antihistamine, it should increase your appetite.
- Scott
Posted by qbsbrown on August 14, 2009, at 11:44:33
In reply to Re: My options, posted by SLS on August 14, 2009, at 0:30:32
> > Well at this point, I can continue on on my own route. I'd probably sadly have to add an AD (I might go Doxepin rather than a SSRI) to be able to sleep a little and to be able to eat. I HAVE to be able to eat.
>
> It sounds like a reasonable plan. Doxepin has survived the test of time in demonstrating efficacy for depression, anxiety, and insomnia. Being an antihistamine, it should increase your appetite.
>
>
> - ScottWell the antihistamines seemed to help a little bit, but when they wore off, it made things worse. But yes, while they worked, it greatly helped my appetite, and some anxiety was decreased. It might be worth a look at.
Regards,
Brian
Posted by qbsbrown on August 14, 2009, at 17:18:58
In reply to Re: My options, posted by qbsbrown on August 14, 2009, at 11:44:33
Wow Scott, Doxepin is 700 times more potent than diphenhydramine. I couldn't imagine the eating and sedation from that, wow. If the histamines were making it worse after they wore off, then i wonder if this is good. I mean that i'd get like chest tightness. But i know that antihistamines can cause some heart probs, as can TCAs.
Worried,
Brian
Posted by qbsbrown on August 15, 2009, at 14:52:10
In reply to Re: My options, posted by qbsbrown on August 14, 2009, at 17:18:58
Now that I am somewhat acustomed to the tegretol, do you think that my brain/body would accept trileptal now? I think the two benefits would be that it might not be lowering the diazepam levels, and that i think the tegretol is giving me quite bad rapid heart beats, arrythmias, which i had a minor surgery for 10 years ago.
I started this taper on trileptal,, and although i hated it, and what it induced, it allowed me to cut from 30mgs to 10mgs in 10 days. It might be arrogant and wishful thinking to think that it would do the same now.
I see it is quite an easy crossover, tegretol 200mgs=300mgs of trileptal, so I'd be on 1200 trileptal.Also, with trileptal, i had to dose just as often with the peaks and valleys.
Your opinion? Gone to that well too many times?
Brian
Posted by SLS on August 15, 2009, at 18:39:36
In reply to Scott: Trileptal, posted by qbsbrown on August 15, 2009, at 14:52:10
Hi Brian.
> Now that I am somewhat acustomed to the tegretol, do you think that my brain/body would accept trileptal now?
Your guess is as good as mine. You are experiencing idiosyncratic negative reactions to these drugs, and I don't know why.
I think the two benefits would be that it might not be lowering the diazepam levels.
Yes, but that should not be a factor at a steady dosage of Tegretol in that you can make an adjustment to the diazepam dosage.
> and that i think the tegretol is giving me quite bad rapid heart beats,
Doxepin is more likely to do that. Do you have diagnosed conduction irregularities? If so, where is the irregularity located?
Personally, I would try Trileptal if I were trying to discontinue diazepam. Unfortunately, you reported having had a bad reaction to it. What would be different this time?
How do you plan to make the switch from Tegretol to Trileptal? Were you going to cross titrate or simply switch over?
I recommend that you write down what you experience with these drugs so that you have a record you can refer to in the future.
- Scott
Posted by qbsbrown on August 15, 2009, at 19:29:33
In reply to Re: Scott: Trileptal, posted by SLS on August 15, 2009, at 18:39:36
> Hi Brian.
>
> > Now that I am somewhat acustomed to the tegretol, do you think that my brain/body would accept trileptal now?
>
> Your guess is as good as mine. You are experiencing idiosyncratic negative reactions to these drugs, and I don't know why.
>
> I think the two benefits would be that it might not be lowering the diazepam levels.
>
> Yes, but that should not be a factor at a steady dosage of Tegretol in that you can make an adjustment to the diazepam dosage.
>
> > and that i think the tegretol is giving me quite bad rapid heart beats,
>
> Doxepin is more likely to do that. Do you have diagnosed conduction irregularities? If so, where is the irregularity located?
>
> Personally, I would try Trileptal if I were trying to discontinue diazepam. Unfortunately, you reported having had a bad reaction to it. What would be different this time?
>
> How do you plan to make the switch from Tegretol to Trileptal? Were you going to cross titrate or simply switch over?
>
> I recommend that you write down what you experience with these drugs so that you have a record you can refer to in the future.
>
>
> - ScottLOL. I think we might be screwed scott, and might have to endure this solo. The only other considerations i think are topamax, which never caused dysphoria or depression, but only derealization and stupidity. But then again, it seems that almost anything I try that deals with GABA, even vitamins and supplements, seem to have an adverse effects. It might just be so sensitive.
That, or phenobarbital. I hate the anticonvulsants, and have found them all very harsh, and I've hated them, even when i wasn't in serious WD.
Phenobarbital is more of a barbituate than an anticonvulsant? Or is it both? Is it supposed to be smooth?
Then again, depakote always seemed smooth to me, but in this state, hit me like a ton of bricks.
I think that a detox clinic is crazy and asking for psychosis and delirium, and then thrown back on to the streets.
2 clinics that i've already spoken to have mentioned tegretol. 1 assumed i was taking it, the other said it would be administered. I think that 1 would add phenobarbital.
but it's been one month on tegretol, and i haven't been able to lower my dose. I was lowering 1mg every 2 weeks.
Sure, it was great to be able to leave the house and go to an Island, and some parts were ok. But most of it was depressing and dysphoric. When on it, all that I hear are ugly voices from the drug
24/7. It's taken away my muscle spasms and my serious sweating that's nice. My paranoia of eating other foods is gone that's nice.
Talking to other people can be nice.But I think this is a big trade off that might not worth it.
What is the protocol for coming off? 200mgs every 5 days?
There might be a huge backlash from coming off that I'm very afraid of. I was doing well with my taper, then came off cold turkey off trileptal a while back, and all hell broke loose. There was even some to pay for the 2 days of depakote.
I might be screwed.
There is a benzo expert in my area who has referred me to an addiction specialist who is very receptive to what I'm going through.
Brian
Posted by qbsbrown on August 15, 2009, at 19:39:39
In reply to Re: Scott: Trileptal, posted by qbsbrown on August 15, 2009, at 19:29:33
Ok, if I continued with tegretol, today is day 5 on 800. Would you recommend dropping diazepam after 1 week?
You're right, the definition of insanity, would me trying trileptal on this taper again. I've tried it maybe 3 other times on the taper. The first time, had I continued, it might have been ok. But as I got further into the taper, it was too harsh, and i saw the mixed mood episodes coming back.
I haven't tried or taken the doxepin yet. I'm pretty afraid to.
Brian
Posted by morganator on August 15, 2009, at 20:26:50
In reply to Re: Antihistamines; is it just me or?, posted by qbsbrown on August 11, 2009, at 22:55:29
Sorry for getting back so late..I think it was one of the brand names you mentioned..Hydroxyzine is the generic name
Posted by morganator on August 15, 2009, at 20:29:33
In reply to Re: Antihistamines; is it just me or?, posted by qbsbrown on August 12, 2009, at 12:01:17
The brand name is Atarax or Vistaril. Sounds like you are having success with the ones you have tried so maybe you don't need a script for this.
Posted by qbsbrown on August 15, 2009, at 21:10:59
In reply to Re: Antihistamines; is it just me or?, posted by morganator on August 15, 2009, at 20:29:33
Oh, I didn't try any. the unisom and the benadryl helped me tempoarily, but when they wore off, worsened my situation. Ended up giving me panic attacks.
I'm basically screwed at this point. I really messed up my taper. I'm in utter confusion and basically delirium. The doc I spoke with, whom I trusted, said that I was at the point of doing an acute (highly supervised, monitored) detox. I think he's right.
Posted by qbsbrown on August 15, 2009, at 21:45:31
In reply to Re: Scott: Trileptal, posted by qbsbrown on August 15, 2009, at 19:39:39
Are the Trileptal and Tegretol not interchangable? Can you not switch them out? You have to cross over gradually?
Brian
Posted by qbsbrown on August 15, 2009, at 22:44:58
In reply to Re: Scott: Trileptal, posted by qbsbrown on August 15, 2009, at 21:45:31
Who knows, I might just say screw it, and go to 1000mgs tegretol.
It's wearing off and my head feels on fire, like the high/on acid/speed/interdose interdose/cold turkey withdrawal feeling.
Funny how this thing changes hourly.
Posted by qbsbrown on August 15, 2009, at 23:24:42
In reply to Re: Scott: Trileptal, posted by qbsbrown on August 15, 2009, at 22:44:58
Do you not think that a stable dose of 800mgs of tegretol is not eating the diazepam, and is it still eating itself?
Brian
Posted by qbsbrown on August 15, 2009, at 23:57:19
In reply to Re: Scott: Trileptal, posted by qbsbrown on August 15, 2009, at 23:24:42
Do you think that I need to updose 1mg or 2 of diazepam?
Posted by morganator on August 16, 2009, at 0:32:12
In reply to Re: Antihistamines; is it just me or?, posted by qbsbrown on August 15, 2009, at 21:10:59
Acute detox may be the way to go. If you can do it why not. At least you tried.
Posted by SLS on August 16, 2009, at 6:30:50
In reply to Re: Antihistamines; is it just me or?, posted by morganator on August 16, 2009, at 0:32:12
> Acute detox may be the way to go. If you can do it why not. At least you tried.
Yes. I think this is one for the professionals.
Brian, I'm sorry that things didn't work out with the Trileptal / Depakote / Tegretol. Yes, there is data reporting efficacy of Topamax in BZD withdrawal, but I think you should be evaluated and monitored in a facility that is dedicated to substance detoxification.
- Scott
Posted by qbsbrown on August 16, 2009, at 17:05:08
In reply to Scott: Trileptal, posted by qbsbrown on August 15, 2009, at 14:52:10
Scott, if I've been taking the generic immediate release 200mgs x4 of tegretol, can i simply switch to the er version, 400mgs 2 times a day? Or will that be an adjustment period at this point?
Personally, I don't care at this point in time.
Regards,
Brian
Posted by SLS on August 16, 2009, at 20:04:03
In reply to Scott: Tegretol, posted by qbsbrown on August 16, 2009, at 17:05:08
> Scott, if I've been taking the generic immediate release 200mgs x4 of tegretol, can i simply switch to the er version, 400mgs 2 times a day? Or will that be an adjustment period at this point?
I don't know for sure.Although I wouldn't recommend it to someone else without having more information, I know that if it were me, I would simply start taking the ER version tomorrow at 800mg. Maybe you can perform a search on Google. Of course, the best thing to do is to speak to a doctor who works with these drugs.
- Scott
Posted by qbsbrown on August 17, 2009, at 17:05:10
In reply to Re: Scott: Tegretol, posted by SLS on August 16, 2009, at 20:04:03
Is the safest/fastest that I can come off is 200mgs every 5 days? Or can I go quicker?
I am re-instating from a point where i will not be in severe tolerance wd, and can have some resemblence of a life.
Seeing as there aren't going to be many docs around that will prescribe 60-80mgs valium (basically a sugar pill to me), and klonopin causes depression/irritability, ativan is a sugar pill, is my best bet xanax xr (I worry about tolerance and interdose wd? Given that i have to dose valium 3 times a day, im imagining that i'd have to take it 4 times a day.
As to the underlying depression might be lingering, the only beneficial med i found was provigil. I worry that it is a cns stimulant, and benzos a depressant, damaging my cns.
The best relief i ever found was an ssri+provigil. It might be worth looking into.
I had good results w/ celexa+provigil, but celexa causes dereliazation. Not a side effect i'm willing to deal with. Lexapro+provigil might be worth looking into. As lexapro is the only one that has helped depression and helps derealization. But bad for sleep, has induced some mania, mixed/moods before, and some dysphoria, which i think the provigil might help with.
Let me know what you think
Regards,
Brian
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