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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by Llurpsie_Noodle on February 17, 2007, at 22:44:15
Hi all,
Update on me. I haven't been posting much lately. I have not been feeling so well. There was the period when I had terrible insomnia for a few weeks, and the week when I felt manic- panic for many hours a day.I guess that's what happens when I tinker with my brain chemistry.
I was stable on a cocktail of
300mg seroquel, 120 cymbalta 200 provigil .5 klonopin for about 3 mos. Stable concerning psychiatric symptoms, but my weight was going up up and away!Now I'm unstable on a cocktail of
160mg geodon, 60 cymbalta, 100-200 provigil, .5 klonopin.
I think I'm pretty much through the acute withdrawal from seroquel and cymbalta. I didn't have many side effects at all from starting geodon.
problems are that 1) my mood is uncertain and unstable. 2) I have been having more and more episodes of flashback-terror
Last night I had the worst episode I've had in about 5 months. I have to take the geodon twice a day with food, and I was about 6 hours late with my first dose of the day. crap.
Then I was reading an article in Playboy on combat-related PTSD (really interesting, by the way. recommended reading) and it kind of triggered me, and seeing a show about a psychic criminal investigator who was having flashbacks and such didn't help much either.
By mid-evening, I felt totally psycho. I was losing my notion of single consciousness and single self. Instead I felt this urgent call to destroy myself and it took every ounce of effort to stay in the here-and-now and not succumb to losing consciousness and going back/forward in my imagination. I had to use all my coping mechanisms- some of them healthy, and some not so healthy- just to stay in my body and feel connected.
At some point I realized that I was going to be okay, yet I still felt incredibly strange, like an observer of my own actions rather than an agent. I felt a horrible paranoia and didn't want to post because I was sure I was going to get locked up or do something regrettable.
Part of me wanted to be saved and helped and part of me did everything possible to prevent that.
in short a pretty dangerous evening. :( And I felt lucid throughout all of it, but not in control. dunno if THAT makes any sense?
Well, I guess some pharmacologic changes are in the works. I suppose some of those feelings fall into the category of "psychotic", since I definitely lost track of reality (paranoia, dissociation, depersonalization, loss of free-will...).
I didn't realize that 6 hours and a missed dose separates ME from PSYCHO. Now I guess I have to figure out how to give myself a little more wiggle-room, since stress happens.
I do feel a lot more PTSD'd than I have in a LONG time.
what are my options? increase geodon, try another atypical antipsycho? try another AD? all of the above?
mix of seroquel and cymbalta was great for my moods, but not so good for my body...
sorry so long.
-Ll
Posted by exquilter on February 18, 2007, at 0:21:26
In reply to pharmacological changes? *trigger*, posted by Llurpsie_Noodle on February 17, 2007, at 22:44:15
I'm sorry you are feeling so rocky right now. I noticed that the Geodon seemed to be worsening my mood instead of improving it. I only got to 60mg for a few days before it was clear that it wasn't a good med for me. All my others stayed the same so the irritability and self doubt and increased anxiety can't be attributed to withdrawal. It is possible that the additive effect caused the problem I suppose, I am feeling a bit better each day the longer I'm off it. I guess it will be back to the drawing board for me too.
Exquilter
Posted by laima on February 18, 2007, at 9:12:17
In reply to Re: pharmacological changes? *trigger* » Llurpsie_Noodle, posted by exquilter on February 18, 2007, at 0:21:26
Why did you decide to go down on cymbalta? I wonder if geodon maybe isn't as effective for you as seroquel was. An out-on-limb speculation, would it be safe or desirable to try seroquel again, but with an appetite suppressent med of some sort along with it? Would that work, I wonder? Or was it more that seroquel messed with your metabolism? I'm so sorry to hear you haven't been feeling well.
Posted by ronaldo on February 18, 2007, at 10:35:47
In reply to pharmacological changes? *trigger*, posted by Llurpsie_Noodle on February 17, 2007, at 22:44:15
Ll
Have you considered knitting as a means of keeping your mind focussed? Or perhaps crochet? A free wheeling mind is likely to get up to mischief. Talking from personal experience.
ronaldo
Posted by Phillipa on February 18, 2007, at 10:42:20
In reply to Re: pharmacological changes? *trigger* » Llurpsie_Noodle, posted by ronaldo on February 18, 2007, at 10:35:47
Lurpsie what does pdoc say? I think the weight gain will happen on any of the atypicals and any antidepressant. And you haven't gained much weight . Maybe the same for a bit longer the seroquel and the cymbalta? Love Phillipa
Posted by med_empowered on February 18, 2007, at 13:21:40
In reply to Re: pharmacological changes? *trigger*, posted by Phillipa on February 18, 2007, at 10:42:20
Geodon makes some people more agitated. If seroquel worked, maybe you could try it again, with Metformin and/or a weight-reducing drug (Adipex, Bontril, Didrex, Meridia, so on, so forth) added into the mix? Maybe drop the atypicals altogether and go for a higher dose of the benzo? .5mgs/Klonopin isn't much; lots of people take 1-3, and some people take more than that, so you have room to go up on that. Maybe a different AD? Weight gain would be an issue, but Surmontil might help--its a tricyclic that's kind of clozapine-esque. Its good for sleep and in high doses helps psychosis, so maybe that'd be an option.
Good luck!
Posted by Llurpsie_Noodle on February 18, 2007, at 22:22:38
In reply to Re: pharmacological changes? *trigger* » Llurpsie_Noodle, posted by ronaldo on February 18, 2007, at 10:35:47
> Ll
>
> Have you considered knitting as a means of keeping your mind focussed? Or perhaps crochet? A free wheeling mind is likely to get up to mischief. Talking from personal experience.
>
> ronaldoRONALDO!!!
are you spying on me?
knitting is my new obsession. I am into week 4 of knitting, and I have 5 completed projects under my belt. The next one is well underway. a baby sweater. A few twisted stitches in the sleeve, but no major boo boos just yet.Just so that this doesn't get moved... I have found that I have about 4 different mental speeds + crisis
1 = sleeping
2 = restless but wish I were sleeping
3 = knitting, housework
4 = dissertatingand then reverse = splitting of consciousness and imminent self-destructive crisis.
so... I have gotten fairly good at spending most of my time at speeds 1,3,4. Using moderate amounts of self-help instropsection, provigil and klonopin to try to avoid the 2nd speed at all costs. THAT one sucks big time.
The crisis kind of caught me off guard though. Knitting was there, but it was far too fuzzy and cutesy to attract the attn of my demons.
-Ll
Posted by Llurpsie_Noodle on February 18, 2007, at 22:28:41
In reply to Re: pharmacological changes? *trigger* » Llurpsie_Noodle, posted by exquilter on February 18, 2007, at 0:21:26
> I'm sorry you are feeling so rocky right now. I noticed that the Geodon seemed to be worsening my mood instead of improving it. I only got to 60mg for a few days before it was clear that it wasn't a good med for me. All my others stayed the same so the irritability and self doubt and increased anxiety can't be attributed to withdrawal. It is possible that the additive effect caused the problem I suppose, I am feeling a bit better each day the longer I'm off it. I guess it will be back to the drawing board for me too.
>
> ExquilterI'm sorry to hear that. I didn't notice much of anything when I started the geodon. more energy perhaps. The bad feelings started when I was weaning off of seroquel.
I'm eating a fudge bar with my geodon right now. kinda hard to type one-handed. I think that's why I was late on the dose on friday- 'cause i forgot to take it with lunch. I was off my rhythm.
my cat is very excited about a yarn scrap right now. lol
-Ll
fyi, geodon has to be taken with food to be absorbed at the right dosage.
Posted by Llurpsie_Noodle on February 18, 2007, at 22:39:18
In reply to Re: pharmacological changes?, posted by laima on February 18, 2007, at 9:12:17
> Why did you decide to go down on cymbalta?
because both geodon and cymbalta have serotonin and norepinephrine reuptake properties.
cymbalta was killing my sexual response. I felt stable and anti-depressed but changes needed to be made.
the combination of seroquel and geodon pretty much sent my gut on a 2 week vacation. There wasn't much work being done on the digestive end of things... um yeah. (blushing)
>I wonder if geodon maybe isn't as effective for you as seroquel was.
Yep. a distinct possibility...
>An out-on-limb speculation, would it be safe or desirable to try seroquel again, but with an appetite suppressent med of some sort along with it? Would that work, I wonder? Or was it more that seroquel messed with your metabolism?
I was hoping to take FEWER drugs, not more drugs. :( I think seroquel gave me munchies for sweets and carbs in particular, and I worry about it increasing my risk for diabetes, which affects both my parents. I used to have pretty abrupt drops in blood sugar, and that hasn't been a problem since I've been off the seroquel.
I'm gonna push for a higher dose of geodon first. especially since I haven't been taking as much of my BZD as doc tells me to (bad llurpsie) I better go take another tablet so that I can meet my quota of calm karma before I turn into a pumpkin at midnight.
> I'm so sorry to hear you haven't been feeling well.
Thanks laima, was that you who left the fudge bar in my freezer? :)
Sllurpsie
Posted by Phillipa on February 18, 2007, at 22:39:18
In reply to Re: pharmacological changes? *trigger* » exquilter, posted by Llurpsie_Noodle on February 18, 2007, at 22:28:41
Lurpsie are you knitting for a little one on the way is that why the rush to get off the meds? I still say stay with the seroquel and the cymbalta longer. Are you still a pot watched? Love Phillipa
Posted by Llurpsie_Noodle on February 18, 2007, at 22:47:00
In reply to Re: pharmacological changes? *trigger*, posted by Phillipa on February 18, 2007, at 10:42:20
> Lurpsie what does pdoc say?
pdoc says that weight gain is likely due to seroquel.
I've got an appt. this week, and I'm about 90% sure that we're gonna change things. The details remain to be settled...
>I think the weight gain will happen on any of the atypicals and any antidepressant.
Some of them have higher weight gain tendency than others. cymbalta is neutral. seroquel- can go either way. Depends on an individual, but THIS individual found weight gain to be very real. I turned into a hungry craving monster.
>And you haven't gained much weight.
I gained a pound a week for 3 months. That's about 10% of my body weight, increased in solid blubber. I think that's clinically significant.
> Maybe the same for a bit longer the seroquel and the cymbalta? Love Phillipa
Thanks for your concern Phillipa. I dunno what's going on with my brain chemistry, but I'm definitely liking the sense of no-munchies. I think I've lost about 3-4 lbs and can fit into more of my regular pants than since before X-mas. I have hesitation to go back on seroquel. Weight gain is bad for my mood and my self-esteem, and of course has bad health consequences too.
-Ll
Posted by Llurpsie_Noodle on February 18, 2007, at 22:52:10
In reply to Re: pharmacological changes? *trigger*, posted by med_empowered on February 18, 2007, at 13:21:40
> Geodon makes some people more agitated. If seroquel worked, maybe you could try it again, with Metformin and/or a weight-reducing drug (Adipex, Bontril, Didrex, Meridia, so on, so forth) added into the mix?
hmm. interesting idea... pdoc and I were hoping to reduce the meds, not increase them. I'm on quite a cocktail already.
Geodon def makes me more agitated. However, sometimes I'm able to funnel that agitation to good ends. My place is very very clean, and my diss work is progressing nicely. Sleeping... well, apparently my body says that 6 hours at night and 1 hour nap is good enough. I'm trying to limit caffeine, but coffee is SO good in cold weather ((((decaf))))
Maybe drop the atypicals altogether and go for a higher dose of the benzo? .5mgs/Klonopin isn't much; lots of people take 1-3, and some people take more than that, so you have room to go up on that. Maybe a different AD?Atypicals might be necessary for the time being, especially since my last crisis had a lot of psychotic features. (isn't that just fantastic?)
I wonder what the verdict will be on the AD. I just can't wait (half true, half sarcasm)
Weight gain would be an issue, but Surmontil might help--its a tricyclic that's kind of clozapine-esque. Its good for sleep and in high doses helps psychosis, so maybe that'd be an option.Interesting. I'll look it up.
> Good luck!
thanks- I need any little lucky charm I can find # oh look! there's one @ and another * bling! % whee
nightienight
-Ll
Posted by Llurpsie_Noodle on February 18, 2007, at 23:18:53
In reply to Re: pharmacological changes? *trigger* » Llurpsie_Noodle, posted by Phillipa on February 18, 2007, at 22:39:18
> Lurpsie are you knitting for a little one on the way is that why the rush to get off the meds? I still say stay with the seroquel and the cymbalta longer. Are you still a pot watched? Love Phillipa
dear GOD,
NO babies for me this year.
Thank you,
-Llurpsieall my friends are pregnant though. seems like a good time to learn how to knit.
on second thought, maybe no sex is not such a bad thing after all... lol
no sex = no brain-damaged llurpsy psycho babies.
Posted by laima on February 19, 2007, at 8:48:40
In reply to Re: pharmacological changes? » laima, posted by Llurpsie_Noodle on February 18, 2007, at 22:39:18
Fudge bar? Not me, I would have likely eaten it myself :)Yes, I can definately relate to the idea of wanting to use fewer meds, not more. The side effects sound to be a bit much, as you describe. No use in developing side effects which in themselves become new problems, either. I experienced a bit of that myself with my brief zyprexa stint- yikes. (But the weight's nearly off now- gained approximately 10 pounds over zyprexad holidays.)
Could part of your current difficulty have to do with cutting cymbalta and trying a switch from seroquel all at once? Maybe it's a shock to your system? I don't really know, I'm just hopeful for you to succeed, and comfortably. You've mentioned feeling you are through with withdrawals, so that in itself should hopefully make a difference going forward. My unscientific and entirely intuitive hunch is that as soon as meds are restabilized, you'll feel better. Sounds that you have a sensible plan cooking, ie in giving the geodon a fair trial, everything well thought out, and I've got my fingers crossed for you.
This is the end of the thread.
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