Posted by tonyz on June 19, 2009, at 10:47:42
In reply to Re: Question about med combinations, posted by morganpmiller on June 19, 2009, at 2:21:01
Really appreciate all the responses I have gotten from everyone. When this started in November I started taking clonazepam and nortriptyline then added seroquel to the mix.
In January I had gotten up to 200mg of Seroquel, 175mg of Nortriptyline and was taking 1mg Clonazepam. I had gone from 150 of Seroquel to 200mg in 1 day.
Then I switched the clonazepam to valium (20mg) to start tapering. I was tapering the valium about 2.5mg every 4-5 days while also tapering the seroquel roughly 25mg every 4 days. I reduced the Nortriptyline to 150mg.
Got off the Seroquel had the valium at 7.5mg and the Nortriptyline at 150mg. I was feeling better but quickly relapsed.
The doc said I got of the Seroquel too quickly. Ok so I tried taking it again for 5 nights 50-50-25-25-25. Just couldn't do it -- I had too much anxiety over taking the Seroquel (or any anti-psychotic for that matter). The doc knows I don't like the seroquel so he prescribed wellbutrin (100mg) as an augment for the Notriptyline. Stayed on that for about 2-3 weeks. I felt a little something from the Wellbutrin but it wasn't doing the trick sleep was erratic but I was getting some sleep each night. Valium also went up during this time between 10-15mg. Would vary.
Apparently around mid March I started feeling better because the Nortriptyline was down to 100mg and and the valium was at 7,5mg getting tapered by about 2.5mg every 4 days. I was getting good sleep according to my records. I continued tapering the NTP and valium and got it down 25mg NTP and 2.5 mg valium. This was early April.
Then I started having sleep issues again so the Valium went up to 8mg and the trazodone was added
(100mg a night). The combination of the trazodone and valium was very sedating intitially but then I would awaken during the night.I had taken Sam-e with some success in the past so started down that route. Pdoc knows I don't like meds so he suggested it but didn't give me any guidelines. Did 400mg for 3 days, then 600mg for 3 days. I think I had some reactions and sleep was starting to deteriorate. I was also taking the valium at this time which had been increased to 10mg.
Then I saw another doctor but in the same office, I told her I really didn't like taking meds but I needed something for sleep she had suggested raising the sam-e to 800mg and taking 7.5mg remeron for sleep Valium was 10mg at this time.
The remeron seemed to help with sleep, initially but then stopped working so began back with the seroquel and Notriptyline and the valium ramped back between 17.5 and 20mg. The remeron and Sam-e were stopped.If I read some of the postings on the benzo withdrawal boards which someone was kind enough to point out from this group, that sounds like me:
the depersonalization, very bad memory problems, poor concentration, having trouble remembering the sequence of events during the day, etc.I tell this to my pdoc and he says you need to think about hospitalization. The problem I have with this is 1)the loss of control in the sense that you feel more compelled to follow their recommendations exactly - it is a day program you just go during the day and there are different group sessions. Generally start off by rating depression and anxiety every day, and then to other groups. You usually meet with your doctor every other day for maybe 10-15 minutes and he makes adjustments to your medication. I don't think I want to do this again. I have to admit it did work for me last year.
The neuroleptics scare the c*** out of me, but being in this state is not good either.
Right now the Nortriptyline is at 150mg, the seroquel 200mg and the valium 19mg - so I caved in last night. I estimate I got about 5-6 hours sleep and there was dreaming, but I feel like crap this morning, I guess I was a bit agitated by some of the postings because it made me think that perhaps these meds are screwing me up.
Doctors typically look at past experience and that is their starting point. I keep very good records of what I take, but now since I have the history of improving when on Seroquel at 400mg, 125 of Nortriptyline and 20 mg of valium and abilify that is probably going to be the starting point.
Seroquel has the potential for a lot of serious health issues - other than being very shaky last year I was fortunate in not incurring any of the other side effects with the exception of my cholesterol being raised slightly but I can't blame that on the seroquel for sure.
If you've read this far I am very grateful. What do you think about adding L-tryptophan and/or benadryl, scaling back on the valium. I also have some temazepam but it is just a few months past its expiration. That is also an option. The seroquel - I would just scale back by 25mg a night. On a Friday, the probability of finding a doctor and getting an appointment for today is going to be nearly impossible.
The pattern last night was no different sleep wise. I alternate between a few hours 1 day and better the next day so I don't think the additional valium and seroquel did very much.
Guys and Gals if I ever get out of this hole I'll will try to contribute as much as I can to this group. I really appreciate all of the responses.
poster:tonyz
thread:901793
URL: http://www.dr-bob.org/babble/20090611/msgs/902037.html