Posted by Mitch on November 5, 2001, at 10:02:00
In reply to Consensus on withdrawing from meds under Dr's care » Mitch, posted by AnneL on November 4, 2001, at 22:42:35
> >Hi Mitch,
>
> You make an interesting point. But I do notice that I am definitely hyperfocused at work and am noticing that although I am moving extremely fast (mind, my movements), instead of accomplishing more, I find that I am going off on tangents (fun tangents, very creative time). My former Pdoc has suggested that I get my meds evaluated for the addition of a possible mood stabilizer. My new Pdoc wanted me to consult with my endocrinologist about my TSH levels during the last 2 years to make sure that I was not "over-treated" and in a hyperthyroid state which would have accounted for my 1 1/2 year obssession with weight loss (43 pounds), exercise, running 6 days out of the week and at the gym 4 to 5 nights a week, and my hyperfocused attention to the Weight Watchers program (I took it to a new level and then some!) I alienated my family and children, could not sit down and watch tv for more than 5 minutes and slept (and slept well! for about 4 to 5 hours at night to begin a brand new day of running, taking care of family (more like taking care of myself),going to the gym and monitoring my food). My guess is, and I will talk with him this week is that he wants to rule out a Bipolar II (?) diagnosis before adding a mood stabilizer vs. a thyroid-medication induced episode.I didn't realize that you were on thyroid meds! I just got a letter back from my endo. and my TSH was 1.4. I was convinced I was hyperthyroid over the last few weeks, but I have just been a little hypomanic I guess.
Yep, it sounds like your energy level is getting a little "pegged"! FWIW, Effexor has been known to trigger hypomania fairly frequently in susceptible people. You mentioned going "off in fun tangents", well that is fairly tell-tale for hypomania. I would suggest backing off the Effexor somewhat and see if that takes a little wind out of your sails before you start adding more meds and inadvertently complicate things.
>
> Consulted with my endocrinologist and I am properly treated at proper levels (no incredibly low TSH levels and the only time I had difficulty with my Synthroid was when one wacko primary care upped my dose from 150 mcg of Synthroid to 200 mcg of Synthroid for a very slightly elevated TSH which could have been due to either calcium intake or iron supplementation. I did have palpitations and insomnia during the 3 week period which quickly went away when I backed down to my original dose of Synthroid. No mania, just anxiety and palpitations.
>
> Since I am only on an AD and Klonopin, wouldn't one expect me to get "worse" without the addition of a mood stabilizer if in fact I had some type of Bipolar diagnosis? I have not lapsed into any vigorous exercise or diet program since my descent into depression when my whole world came tumbling down (that was a good thing). To the contrary, I cannot get motivated to stay with any exercise program or diet at all since I started Effexor. I just don't have that motivation anymore (in all honesty, I miss that former part of my life, I was really *happy*, completed 2 half marathons, etc.) So why add a mood stabilizer if I have not had any more episodes of going off the deep end by over-dieting and exercising? I don't overspend, behave in risky behaviors, etc, but did have quite a time as a teenager and in my twenties by doing stupid things. I do have periods of time of intense happiness. But then again, maybe it just feels intense, because feeling low sucks. One other thing that may be complicating this whole thing is for the last 3 months I have been on a very small dose of progestin for the control of very heavy menstrual periods (menorrhagia) which is working like a charm, but could be causing some of my low moods, but cannot explain the energetic
> moments and creative periods of time.
>
> I am giving serious thought to tapering off both Effexor and Klonopin to find out where I'am at. I am of the belief that I experienced a mid-life crisis and reacted to turning 40 by trying to get slim and in shape, but ended up over doing it for what I will admit was a fairly long time (1 1/2 years). I also believe that my intense reactions to some serious problems my children were having also led to my depressive episode. These issues are resolving.I would alter one factor at a time if it's possible to do so. IMO, The Effexor is just wiring you for sound. Ask your doc about dropping the dose from 225mg to say 150mg for a couple of weeks and see if all this settles down some. You may just need a lowered dose. If it is keeping you out of major depression you may need to take some maintenance dose of an AD indefnitely. From reading your response I don't detect any euphoria, you just sound "fast" not "high".
Hope this helps.
Mitch>
> How do others feel about discontinuing meds (if I can even get my Pdoc to "buy" into this line of thinking)? I don't mean just stopping them, but discontinuing them under a doctor's care and seeing where I am at? I want my life back, whatever that means. Thanks for listening and thanks for any responses. :) Anne
poster:Mitch
thread:83107
URL: http://www.dr-bob.org/babble/20011104/msgs/83252.html