![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 430 to 454 of 458. Go back in thread:
Posted by Latina on May 30, 2004, at 13:25:31
In reply to Re: My med story » BarbaraCat, posted by katia on May 29, 2004, at 3:10:48
has any one out there tried Lamictal and Geodon? I've been on it for about a month and I am better than I've been in years. I have bipolar and fibromyalgia. I've had to quit work as an R.N.I'm not 100% by no means but better. Latina
Posted by sac on May 30, 2004, at 21:07:23
In reply to Re:lamictal for depression, posted by Latina on May 30, 2004, at 13:25:31
Hi, I am curious about your post because I am currently on Lamictal (for bipolar II) and my doctor has also given me Geodon for it's calming and mood stabilizing properties. I took it once or twice and I did feel calmer at night but I have been reluctant to begin it on a regular basis. Can you elaborate on your experience with this combo and what dosages your on? Thanks. -Stacey
> has any one out there tried Lamictal and Geodon? I've been on it for about a month and I am better than I've been in years. I have bipolar and fibromyalgia. I've had to quit work as an R.N.I'm not 100% by no means but better. Latina
Posted by BeckyB on June 16, 2004, at 19:02:48
In reply to Re: Lamictal side effects, posted by St. John on May 11, 2004, at 15:02:27
> > Isn't it facinating that NONE of the literature indicates that Lamictal has the gastrointestinal complications I'm mentioning--nothing that says like other mood stabilizers, some people have the nasuea/distress. Oh well, got to preserve the market.>>
I've been lurking on this board today because I was just given a Lamictal Rx by a neurologist for off-label treatment of spasticity. I've been on some pretty potent drugs for several years and thought I was immune to the "Oh my lord!" effect of reading the "adverse events" section of drug prescribing info, but the one for Lamictal is in a league of its own, so I've been searching for any real life experiences, which brought me here.
Anyway, the package insert for Lamictal lists nausea, vomiting, dyspepsia, flatulence, gastritis, constipation and diahrrea as possible adverse GI effects. It also includes a "black box" warning (repeated several times) of symptoms of a possibly dangerous hypersensitivy reaction: not just the rash and itchiness that have been mentioned several times on the board, but fever plus swollen lymph glands, even without an evident rash.
The entire insert is on-line at http://us.gsk.com/products/assets/us_lamictal.pdf (but be prepared for an "Oh my lord!" reaction; I'll bet GSK's legal department was more involved in producing it than was their marketing department.)
There's also a discussion of Lamictal pros and cons by a patient at http://www.crazymeds.org/lamictal.html, which points out that "when you look at the PI sheet and actually look at the odds you have a 1 in 10 chance of getting some kind of rash with Lamictal. Not necessarily The Rash, just some random rash." I think he underplays the potential seriousness of a rash (e.g, he says "Once you see the first symptoms and stop taking Lamictal, The Rash goes away and you're safe! Problem solved!" -- not necessarily so, according to the PI. But the site still has good info, including what seems to be a decent translation of some of the incredibly complicated titration/discontinuation schedules recommended by GSK, and potential interations.
Posted by barbaracat on June 17, 2004, at 17:24:31
In reply to Re: Lamictal side effects (GI, The Rash others) » St. John, posted by BeckyB on June 16, 2004, at 19:02:48
Hello Becky,
I hope you will benefit from some hard-won experience from Lamictal and 'the Rash'. I've related my story in other posts, but if I can do anything to forwarn another, here goes again...I was on Lam at 75mg for over a year and it seemed to be doing the trick. At least I felt more 'sparkly' and felt it was helping along with 600mg lithium to control my spins into bleak mixed states depression. I was maintaining. Then my life unraveled during a series of personal trajedies. Depression naturally broke through but was becoming debilitating. So, of course, my pdoc suggested raising the Lam and I slowly titrated up to 150mg. With each increase I felt a little more agitated and began to feel an unbearable intense itch, as though little needles were stinging my skin and scalp. I didn't associate it with Lam since there was no visible sign of rash, more like a heightened skin tenderness. I cut back and it subsided somewhat, increase and it came back. Lam had lost its magic and felt inflaming at every level. I stopped taking it in January of this year.
Then in March I began a course of oral DMPS to chelate a high level of mercury toxicity I tested positively for. Most people don't get any reaction to DMPS but it does depend heavily on methylation and detoxing itself can be a heavy drain. I first got severe racking chills, then a fever. But I continued taking it thinking I was coming down with a cold or something. Then came the severe external rash that quickly spread to my internal mucous membranes. Not fun. I ended up with Stevens Johnson Syndrome, spent time in the hospital and was quite ill for 5 weeks. Although it was not directly attributable to the Lam, I feel that the itching and skin sensitivity was a prelude and sensitizing. Something in my chemistry was being constantly irritated. I was being harmed and I was being warned.
I've since found out much about sulfanization, methyl doners, and some of us are genetically deficient in an enzyme needed in this process. But the immune system is pretty adaptable, and as long as it has what it needs, life goes on. Glutathione is what bolsters the immune system to withstand assaults. However, very depressed, stressed, worn out and ill people have been shown to have low glutathione reserves. In other words, one may be genetically predisposed to a particular weakness, in this case, one that depends upon methyl doners and conversions of sulfer type compounds. Lamictal and many other drugs use this pathway. We take hits on our immune system constantly. If there's a hiccup along the way, the immune system can usually handle it, but put enough stress into the picture and it can't manage anymore and inflammation results. Inflammation and it's by-products is the key to a whole host of ills, and a skin rash is just one manifestation. Yes, fever, aches, swollen glands, headaches, are other indications of an inflammatory process. Some people are just flat out allergic to a substance - bee venom, peanuts, etc., and know right away. For some it's a slower acclimation process, an allergy that eventually becomes stronger than a weakened immune system can handle.
In hindsight, I now know that my reaction from Lam was a warning that something was awry. It was the straw and set the stage and now I've become sensitive and allergic to many things I never was before. I've learned alot and am now taking nutrients that support the methylation process and my liver and dextox pathways, but I don't know if this is the answer or not. Recovery has been very slow.
You could research deep into the bowels of genetic mutations, thiol groups, cytokines and mast cell involvement until you're up every night until the wee hours. It's very interesting but time's a-wasting. It's enough to know that if you get any kind of adverse inflammatory condition from a med - DON'T IGNORE IT. A 'little rash' is a warning that something ain't kosher with this substance. A big red flag should wave if a doctor tells you, 'oh it's just a small rash and will go away so continue taking your meds'. Grill your doctor - what do they really know other than what the drug companies literature tells them. They're not in the trenches.
Stevens Johnson has been a relatively rare occurrence, but hospital ERs and Urgent Cares are seeing a disturbing rise in cases and they are concerned about indiscrimate prescribing of anti-convulsants. Kids especially are very suseptible. And it's not just Lamictal. Depakote has a bad track record here too. We take these meds so trustingly. I've come to realize that most docs do not have in-depth expertise. It's really up to us to be accountable to our bodies.
Most experience nothing and enjoy the meds many benefits. Maybe the symptoms just mean you're coming down with a flu, contracted a rash somewhere, can shake off a minor allergic reaction. But caution is always necessary. Any rash, weird itch, inflamed touchy skin thing, fever, chills, gland involvement is INFLAMMATION and is your body's way of saying 'Hey! SOMETHING IS WRONG!!'. It might be your medication. That doesn't mean stop all at once, but by all means, reduce your exposure to the allergen. Put it this way - if you suddenly realize you've been sitting in a patch of poison oak, it would be wise to beat cheeks out of there. But you know, most people really don't listen to any of this, and probably hope that living in a patch of poison oak will be preferable to living with depression. - Barbara
> > > Isn't it facinating that NONE of the literature indicates that Lamictal has the gastrointestinal complications I'm mentioning--nothing that says like other mood stabilizers, some people have the nasuea/distress. Oh well, got to preserve the market.>>
>
> I've been lurking on this board today because I was just given a Lamictal Rx by a neurologist for off-label treatment of spasticity. I've been on some pretty potent drugs for several years and thought I was immune to the "Oh my lord!" effect of reading the "adverse events" section of drug prescribing info, but the one for Lamictal is in a league of its own, so I've been searching for any real life experiences, which brought me here.
>
> Anyway, the package insert for Lamictal lists nausea, vomiting, dyspepsia, flatulence, gastritis, constipation and diahrrea as possible adverse GI effects. It also includes a "black box" warning (repeated several times) of symptoms of a possibly dangerous hypersensitivy reaction: not just the rash and itchiness that have been mentioned several times on the board, but fever plus swollen lymph glands, even without an evident rash.
>
> The entire insert is on-line at http://us.gsk.com/products/assets/us_lamictal.pdf (but be prepared for an "Oh my lord!" reaction; I'll bet GSK's legal department was more involved in producing it than was their marketing department.)
>
> There's also a discussion of Lamictal pros and cons by a patient at http://www.crazymeds.org/lamictal.html, which points out that "when you look at the PI sheet and actually look at the odds you have a 1 in 10 chance of getting some kind of rash with Lamictal. Not necessarily The Rash, just some random rash." I think he underplays the potential seriousness of a rash (e.g, he says "Once you see the first symptoms and stop taking Lamictal, The Rash goes away and you're safe! Problem solved!" -- not necessarily so, according to the PI. But the site still has good info, including what seems to be a decent translation of some of the incredibly complicated titration/discontinuation schedules recommended by GSK, and potential interations.
Posted by BeckyB on June 17, 2004, at 17:55:16
In reply to Re: Lamictal side effects (GI, The Rash others) » BeckyB, posted by barbaracat on June 17, 2004, at 17:24:31
Many thanks, Barbara. My neurologist is pretty familiar with Lamictal since it's used for epilepsy, and his emailed instructions to me included: "REPORT ANY RASH PROMPTLY" (his "shouting", not mine).
Posted by katia on June 18, 2004, at 14:17:02
In reply to Re: Lamictal side effects (GI, The Rash others) » BeckyB, posted by barbaracat on June 17, 2004, at 17:24:31
Hi Barb,
How's it going? You are always such a wealth of information. I briefly did a little research on glutathione and it is interesting. About a month ago I did a round with milk thistle as suggested by you. I sometimes do this as I know my liver takes a beating. But I didn't realize how important glut. was. Besides whey protein, what other ways can one increase it? What are you doing now with supplements and diet?
Katia
Posted by barbaracat on June 18, 2004, at 15:47:45
In reply to Re: Lamictal side effects (GI, The Rash others) » barbaracat, posted by katia on June 18, 2004, at 14:17:02
Hi Katia,
Glute is majorly important, not only for general immune health, but some studies have found that it's low in depression - chicken or egg, who knows. Mood disorders sure use up alot of energy. It isn't easily supplemented by itself and seems to work better using precursors. The brand I use, ala naturopath, is Glutathione Precursors by CFS Nutrition (www.cfsn.com). Has N-acetyl-cysteine 257mg, l-glutamic acid 128mg, L-glycine 64mg.I was taking Immunocal whey protein because I was told that it was the best 'whey' to get glute, better than the precurser route. In fact, this was from someone who stressed that glute was really important in building up stores of stamina and strength to get off ADs and the stress caused by depression. I may go back to it in addition to the precursers.
How am I doing? Doing OK, today at least, but yesterday was a bear. It happens when I overextend, don't meditate, get hyper and forget to breathe. Sometimes I simply don't believe that all things pass. Being out of work can be really hard at times. Isolating and stuck. I end up feeling like nothing is getting accomplished or changing, life is a waste, I'll end up poor, sick and alone -- all those dark bag-lady thoughts. But I slept well, it's a new day and life seems kinder.
I'm back on St. John's Wort cause I was drowning in depression. But I've started taking lithium orotate as well and I think it's offsetting the jaggies from SJW. In fact, it's helping alot. I don't think it's a good idea for us bipolars to not be on something. I come back to that every time I try to be pure and natural. I'm only taking 2 li orotate pills a day which is a teeny amount compared to the 600mg lithium carbonate I was on before. It's reputed to be better bioavailable than li carb, which some say is hooey, but I think there may be something to it. I'm not getting any of the lithium side-effects either and hopefully my thyroid won't get dinged like it did on the other. I tried lith orotate last year but didn't feel it was strong enough at the time, especially since I'd stopped li carb and was in the midst of major hypomania. It wasn't enough to pull me out. Recently, with all the detox and lifestyle changes I think I'm in a better position to benefit from it.
My diet is pretty good. Healthy but nothing radical and try to keep it simple. Fresh veggies, fish, chicken, mainly organic, very little sugar. I cook and eat at home mainly, not having many worthwhile eateries nearby, just the usual smalltown watering holes. I'm also taking folic acid 800mg twice a day since it's supposed to be a good antidepressant, sublingual methylcobalamin B12 ditto as an AD and it's the only kind that gets taken into the brain. 1 T Carlson's fish oil, 6M Vit C and a bunch of the usual vitamins and antioxidants like extra CoQ. Taking 1.5 grains natural thyroid and a compounded hormone cream. Ambien to sleep. That's about it, except for periodic neurontin. As long as I don't take it all the time, it helps with occasional real bad anxiety.
I'm also doing a mercury chelation protocol using NDF products (www.bioray2000.com). I sure hope it does the trick. NDF has a good rep and supposedly pulls the mercury out of the brain, which DMPS does not (plus the Stevens Johnson I got from it sucked). So far (3 weeks) I've noticed a lessening in my leg pains and electrical muscle 'pops' that are supposedly mercury caused. We'll see. I know you had your amalgams pulled a while back and it didn't make much of a diff. I don't think I'll go that route. Don't have that many exposed amalgams and I can't afford it anyway. Have you ever had your mercury levels checked? Mine were extremely high and it can't be doing me much good. In fact, I think it's fouling up everything else I try, clogging receptor sites, and responsible for my fibro symtpoms. Of course, exercise is hands down the best thing of all, but I can't (or won't) always do it. Seems like beating a dying horse sometimes.
How are you doing? Sure hope you're still feeling on the upswing or at least steady. It seemed your current medication mix was helping. What's your protocol these days as far as meds and nutritionals?
How's school going? I was signed up for some dance classes but had a crash for a week. Of course, always happens. I'll still go when I can though cause can't let this stuff continue to keep me a recluse. How are you doing with the swampwater and bitches blood? I can't abstain. I just can't and have to admit it. As long as it's moderate and not abusing and I can hold it to a few times a week, it's good enough. Also, wine seems to affect me worse than spirits, so I'm trying to make do with vodka or tequila instead of vino. But it's chardonnay I crave.
> How's it going? You are always such a wealth of information. I briefly did a little research on glutathione and it is interesting. About a month ago I did a round with milk thistle as suggested by you. I sometimes do this as I know my liver takes a beating. But I didn't realize how important glut. was. Besides whey protein, what other ways can one increase it? What are you doing now with supplements and diet?
> Katia
Posted by katia on June 18, 2004, at 18:39:56
In reply to Re: Lamictal side effects (GI, The Rash others) » katia, posted by barbaracat on June 18, 2004, at 15:47:45
> I was taking Immunocal whey protein because I was told that it was the best 'whey' to get glute, better than the precurser route. In fact, this was from someone who stressed that glute was really important in building up stores of stamina and strength to get off ADs and the stress caused by depression. I may go back to it in addition to the precursers.Hi Barbara,
I may go this route as I know my body is rundown from the past few months, not to mention all of my life before this busy time. I'm feeling like I want to live and appreciate this life and fall in love with it and am hoping all the darkness and destruction hasn't already taken it's toll on my body - disease-wise. So I"m trying to implement some support and I seem to be so good at implementing the destructive stuff, like stress, cigs, and alcohol, and coffee.>
> How am I doing? Doing OK, today at least, but yesterday was a bear. It happens when I overextend, don't meditate, get hyper and forget to breathe.**That's me too. I hate to have to be so hypervigliant about "taking good care of myself".
> I'm back on St. John's Wort cause I was drowning in depression. But I've started taking lithium orotate as well and I think it's offsetting the jaggies from SJW. In fact, it's helping alot. I don't think it's a good idea for us bipolars to not be on something. I come back to that every time I try to be pure and natural. I'm only taking 2 li orotate pills a day which is a teeny amount compared to the 600mg lithium carbonate I was on before. It's reputed to be better bioavailable than li carb, which some say is hooey, but I think there may be something to it. I'm not getting any of the lithium side-effects either and hopefully my thyroid won't get dinged like it did on the other. I tried lith orotate last year but didn't feel it was strong enough at the time, especially since I'd stopped li carb and was in the midst of major hypomania. It wasn't enough to pull me out. Recently, with all the detox and lifestyle changes I think I'm in a better position to benefit from it.
** good to hear that Li. Oratate is helping you. Sounds like there is more balance happening in your life.
**Do you take AMbien every night? I'm still on Seroquel and can't seem to find a reason to stop taking something that works.
>Have you ever had your mercury levels checked? Mine were extremely high and it can't be doing me much good. In fact, I think it's fouling up everything else I try, clogging receptor sites, and responsible for my fibro symtpoms. Of course, exercise is hands down the best thing of all, but I can't (or won't) always do it. Seems like beating a dying horse sometimes.
*Nope I haven't. I don't have insurance so I can't see it happening anytime soon. I'm kinda getting to a point where I'm tired of thinking of things that could possibly cause me to be me; even though when it gets bad enough, I can't help but look for reasons as a way out of hell.I suppose my current med cocktail must be doing something for me. 450mg Trileptal 12.5 Paxil and 25mg of Seroquel and 1 tbl spoon Carlson's. I've recently started to do yoga again (which i have to go soon so I"ll make this short(ish).
I'm just done with therapy, coaching, self-help stuff. I need a break and read fiction and stare into the sky and day dream and walk my dog. I've taken another break in grad school and made some changes which I'll go into later. I'm eliminating things now as I took too much on.
>
> How's school going? I was signed up for some dance classes but had a crash for a week. Of course, always happens. I'll still go when I can though cause can't let this stuff continue to keep me a recluse.**I know what you mean. I've own two belly dancing skirts from times of starting and never following through.
**Swamp water occasionally and skunk's blood more often. But normally no more than 1-3 gl. I've been drinking quite a bit over the past few months, but as I stated above - nothing too excessive in one sitting. But too much for me overall. Now I'm taking at least two/three nights "off" a week. Last night I had 1 1/2 and didn't want anymore. I'm starting to feel more centered and when that happens, I don't drink as much.
Keep in touch. Gotta run.
Katia
Posted by Malthus on July 28, 2004, at 7:02:32
In reply to Re: Lamictal side effects (GI, The Rash others) » barbaracat, posted by katia on June 18, 2004, at 18:39:56
Hi Barbaracat and Katia:
I've just spent the past forty five minutes reading your posts to each other and learned so much. (woke up at 5:45 am, didn't get to bed until 2:30am, pretty sure it's the effects of Lam 75mg.) You are both such creative writers! I have a question about Ambien 25.mg/1 at night. My doctor prescribed it last week when she took me from 50 mg. to 75 mg of Lam., but said it was only for the times for when I need to reach into the medicine cabinet because I can't sleep (only prescribed 20 pills). I've been staying up so late at night because I have all this energy which is unusual for me as I'm usually so depressed that sleep is the only relief. She is conservative and says that it's only a short term medication. Well, I've been using it every night (one 25mg. pill). I STILL have trouble falling asleep. How long have you been on the Ambien (can't remember if it was Bcat or Katia). Hope you read this as your last posts on this topic were a while ago. Thanks for your input. Malthus
Posted by katia on July 28, 2004, at 21:24:55
In reply to Re: Bcat and Katia posts and lamictal, posted by Malthus on July 28, 2004, at 7:02:32
> Hi Barbaracat and Katia:
>
> I've just spent the past forty five minutes reading your posts to each other and learned so much. (woke up at 5:45 am, didn't get to bed until 2:30am, pretty sure it's the effects of Lam 75mg.) You are both such creative writers! I have a question about Ambien 25.mg/1 at night. My doctor prescribed it last week when she took me from 50 mg. to 75 mg of Lam., but said it was only for the times for when I need to reach into the medicine cabinet because I can't sleep (only prescribed 20 pills). I've been staying up so late at night because I have all this energy which is unusual for me as I'm usually so depressed that sleep is the only relief. She is conservative and says that it's only a short term medication. Well, I've been using it every night (one 25mg. pill). I STILL have trouble falling asleep. How long have you been on the Ambien (can't remember if it was Bcat or Katia). Hope you read this as your last posts on this topic were a while ago. Thanks for your input. MalthusHi,
I'm not the one who took ambien, it's BarbCat. Sorry i can't help you. I know for me Lamictal was activating in a euphoric way the first time I took it and the second time it was dysphoric and I had to stop. Maybe the side effects of Lam. will wear off. If not, maybe try something else? or use something to help you sleep if it's working for you. I use Seroquel for sleep and it works. Barb tried it and it didn't work for her.
Thanks for the compliment on my writing! I"m not feeling too creative at the moment as my dog just passed away last week and my heart is broken now.
Good luck with your meds.
Katia
Posted by BarbaraCat on July 28, 2004, at 23:35:06
In reply to Re: Bcat and Katia posts and lamictal » Malthus, posted by katia on July 28, 2004, at 21:24:55
Oh Katia,
Oh, I am so sorry. Your little pup. I'd grown to love the little critter - he just reached out over the waves. My heart is with you and I know yours is with me.My wonderful kitty just passed away tonight. My little Merlin was so sick, hanging on for love of life and his folks. He just got so sick and we had our wonderful vet come and send him into the great beyond, the great Adventure. Oh, Katia. Talk to me, sweetie. We have so much in common, my dear sister. Love, Barbara
>
Posted by BarbaraCat on July 28, 2004, at 23:45:18
In reply to Re: Bcat and Katia posts and lamictal, posted by Malthus on July 28, 2004, at 7:02:32
Dear Malthus,
Thanks so much for your wonderful words. Helped me so much since I just lost my beloved kitty tonight. I know Katia was touched as well, for similar reasons. It's amazing how simple reaching out, kind words, can have such a powerful effect, a sweet kindness. Reminds us of what is really important - until we forget once again.I will get back to you with your question. Right now I can't quite wrap my mind around anything, except to know that Life is a gift to be treasured, no matter how shitty it gets. I guess that's the solace and gift we receive from losing a loved one.
BTW, Ambien is pretty great as far as sleep meds go and I think your doc should consider how important good quality sleep is right here and now and not be too concerned over trivialities.
But we'll talk later, Barbara
Posted by katia on July 29, 2004, at 0:36:56
In reply to Re: Bcat and Katia posts and lamictal » katia, posted by BarbaraCat on July 28, 2004, at 23:35:06
> Oh Katia,
> Oh, I am so sorry. Your little pup. I'd grown to love the little critter - he just reached out over the waves. My heart is with you and I know yours is with me.
>
> My wonderful kitty just passed away tonight. My little Merlin was so sick, hanging on for love of life and his folks. He just got so sick and we had our wonderful vet come and send him into the great beyond, the great Adventure. Oh, Katia. Talk to me, sweetie. We have so much in common, my dear sister. Love, Barbara
Hi Dear Barbara,
Grief is a powerful thing. One minute I'm fine and the next, like a wave passing over me I crumple to the floor in agony. I'm sorry about your sweet little Merlin.Oh god. Such an awful awful thing happened right at a time when Rock and I had shifted through things. I had to put him down in my arms at 4 a.m. kissing his head and telling him "Mommy loves you" over and over again.
Five days eariler we had spent three hours with an animal communicator and boy I got such a story from him. He had it FAR worse than I can even imagine. He was soooo smart too. He had so much understanding about our relationship, me, and him and his own demons. At the end of it, we both love each other so deeply and want only the best for the other even if that means sacrificing everything. I've never experienced such a beautiful unselfish unconditional love from both ends. I talked to the communicator just hours after it happened and she said that Rock was grateful for what I did and that he'll only be ok if I"m ok. I was sobbing screaming "I only care about him! I only care if he's ok. Don't worry about me; I can't rest if he's not at peace." Now, I'm at the part of missing him terribly. Something terribly important is missing from this life and that is him. I got his ashes back yesterday and he has shrine in the living room complete with tennis balls and bones. My heart has broken. The animal commuincator says she has rarely met such a special spirit as Rock. She said he was a very old soul. She said he said that he'd never experienced such unconditional love before and these four months have been the best in his life. He now knows he's worthy of such love and will choose such a dignified life in the next one. I just hope we can pass each other again if that is what he wants too.
The communicator told me something like: the level of your grief is only a reflection of the depth of your love.
Your kitty knows it was best for him. He loved you so much that he hung on all those months because of that. But he needed to go and you honored his life by providing that outlet. It is a courageous selfless act.
If we get rerouted to social Barb, just follow the link.
My thoughts are with you Barbara.
Love,
Katia
Posted by starlight on July 29, 2004, at 11:36:27
In reply to Re: Bcat and Katia posts and lamictal ? Malthus, posted by katia on July 28, 2004, at 21:24:55
How would you describe being dysphoric?
Posted by katia on July 29, 2004, at 14:02:46
In reply to Re: Bcat and Katia posts and lamictal - Question??, posted by starlight on July 29, 2004, at 11:36:27
Irritability and agitation. Racy in those ways. Not good ways.
Posted by BarbaraCat on July 30, 2004, at 14:37:49
In reply to Re: Bcat and Katia posts and lamictal, posted by Malthus on July 28, 2004, at 7:02:32
Hi Malthus,
Hopefully I can answer your questions now.>>I have a question about Ambien 25.mg/1 at night. My doctor prescribed it last week when she took me from 50 mg. to 75 mg of Lam., but said it was only for the times for when I need to reach into the medicine cabinet because I can't sleep (only prescribed 20 pills).
**25mg is a high dose for Ambien. I take 10mg, but to tell you the truth, I'm not able to sleep lately even taking extra pills. These past two weeks seeing my cat suffer so have traumatized me. The only thing that gets me to sleep finally is taking a benzo along with the Ambien. I take 5mg Valium to relax my muscles which are currently tight and in knots. Ambien doesn't seem to do much in the way of chilling me, which is what I need most right now - to zone out.
>>I've been staying up so late at night because I have all this energy which is unusual for me as I'm usually so depressed that sleep is the only relief.
**Lamictal can be activating, especially in the beginning and with each dose increase. The best way to deal with this and make it work for you is to find an active outlet. Hard exercise is the best, but any way you can channel that surge of new energy is important. Otherwise it tends to build into tension and insomnia, as you're experiencing.
>>She is conservative and says that it's only a short term medication. Well, I've been using it every night (one 25mg. pill). I STILL have trouble falling asleep. How long have you been on the Ambien.
**I've been on it about 1-1/2 years. Ambien is probably the best of the sleep meds as far as tolerance - much better than the benzos. But you will build tolerance eventually and if your doctor pulls the plug, don't be surprised if you can't sleep for a few nights. You can try benedryl. I take 50 to 100mg on some nights and depending on how wound up I am, it will sometimes push me over the edge into sleep. Sleep has always been a problem for me. I recall lying awake as a child for hours. Some people have a circadian sleep cycle disruption. There's some new evidence that this may be implicated in bipolar disorder.
Perhaps as the Lamictal settles in, sleep will come back and you won't need a sleeper. But if you do, and find that you're just not sleeping, your doctor has to take that as first priority. Sleeplessness is a no-no for bipolars. Really, exercise is the best solution, even though it's the last thing we want to hear. - Barbara
Posted by katia on July 30, 2004, at 16:31:11
In reply to Re: Bcat and Katia posts and lamictal » Malthus, posted by BarbaraCat on July 30, 2004, at 14:37:49
Hi Barb and Malthus,
In Orlando, my mother gave me something to sleep when I got there (plus my seroquel). I was so hysterical, I thought I would die from the grief literally.
Let's see it was - Hydroxyzine HCL 25mg (Atarax). I've never heard of it before, but it helped relax me and I slept for twelve hours that night and then woke up to my 34th birthday. what timing. try celebrating a wedding and birthday while trying to hold grief at bay.
Have either of you heard of this pill?
Katia
Posted by BarbaraCat on July 30, 2004, at 20:38:11
In reply to Re: Bcat and Katia posts and lamictal, posted by katia on July 30, 2004, at 16:31:11
Huh, that's a new one. I did a search and came up with this interesting site with info on all kinds of meds for us mood-challenged folk:
http://www.support4hope.com/medications/anti-manic/hydroxyzine_atarax_vistaril.htm
Seems that Atarax is an antihistamine, which has drowsy qualities. Some people do really well on antihistamines. Sometimes I do well on AH, sometimes I don't - weird. Anyhow, I like the Overdose symptoms near the end of the page: excessive calm. I can handle that.
BTW, HAPPY BIRTHDAY!!!!! Does that make you a Leo or on the cusp? It seems real significant that all this wildness occurred at the start of a new year for you, Katia. A very intense birthday gift, but we can't look those gift horses in the mouth. - Barbara
Posted by katia on July 31, 2004, at 1:09:53
In reply to Re: Bcat and Katia posts and lamictal » katia, posted by BarbaraCat on July 30, 2004, at 20:38:11
July 22 - a cancerian. Pisces moon and Aires rising. Double whammy with sensitivity and Aires for my warrior!
I'll see you over at grief.
katia
Posted by malthus on July 31, 2004, at 11:55:25
In reply to Re: Bcat and Katia posts and lamictal » Malthus, posted by BarbaraCat on July 30, 2004, at 14:37:49
Hi BC and K:
Thanks for your reply. I meant to say I was given 5 mg. of Ambien (not 25 mg. what was I thinking when I wrote that?!), 1 tablet at night for insomnia. When I told Dr. G. that it wasn't helping she said that I shouldn't go any higher than 10 mg. but felt it was better to try something new, Ativan, 0.5 mg., cut it in half at bedtime,take that but have the other half on my nightstand to take if I can't sleep. (She's quite conservative with benzos, which I guess Ativan is). Also, I feel that Lamictal has made me crave caffeine more than usual; are you aware of this side effect? It made me feel a bit hypo, so I cut down on the caffeine and now feel a bit more normal. Dr. doesn't want to increase me on Lam. (presently at 75mg which is nowhere near therapeutic dosing) until next week to tease out if it's the caffeine or the Lam. that's making me feel hypo. Sometimes I feel like a human pincushion considering all the different drugs I've had to try over the past 10 months, but Lam. seems to keep me from feeling so down that I become suicidal.
I feel so supported here and thank you both for your posts to me. Malthus
Posted by malthus on July 31, 2004, at 12:17:23
In reply to oops...mistake on amount of Ambien--BCat and Katia, posted by malthus on July 31, 2004, at 11:55:25
I'm so sorry I didn't say anything in my last post but I am sad about the loss of your pets. I know first-hand how difficult this is; had to have my Winston Cat put to sleep in my arms; I couldn't get out of bed for a week and mourned for a long time after.
"Parting is all we know of heaven and all we need of hell." Emily Dickinson
You are both in my thoughts. Best, Malthus
Posted by katia on July 31, 2004, at 13:16:12
In reply to oops...mistake on amount of Ambien--BCat and Katia, posted by malthus on July 31, 2004, at 11:55:25
Also, I feel that Lamictal has made me crave caffeine more than usual; are you aware of this side effect? It made me feel a bit hypo, so I cut down on the caffeine and now feel a bit more normal.
**Hi Malthus,
Yes, I felt very affected by a cup of coffee (I have one/two every day). I got hypo and euphoric feeling for a couple hours. Lam. is known to be activating like that and it wears away. Again, the second time I tried Lam. I got the dysphoric kind - intensely irritability and agitated.
It does take awhile to find something that works. it took me almost two years to sort it out with a dx and then the right meds. Even now, my med cocktail (Triletpal 450mg, Paxil 12.5mg and Seroquel 15-25mg) is ok. I still am sensitive and such but it's not like it was. This is just me who will never change irregardless of meds.and thank you for your condolences.
Katia
Posted by BarbaraCat on July 31, 2004, at 13:58:55
In reply to Re: Bcat and Katia posts and lamictal » BarbaraCat, posted by katia on July 31, 2004, at 1:09:53
This will be the end of the horoscope stuff, so Dr. Bob doesn't get concerned. Thank goodness for that Aries rising or you'd be in a constant heap. I'm Gemini with Libra rising and Capricorn moon. That Capricorn moon has kept me in check from doing too many stupid things but provides a constant naggy guilt trip. Sun and mercury in the 8th house (death and transformation) which is a pretty heavy aspect and I think my Saturn is in the 12th house. Heavy, heavy and thank God for my sparkly Gemini. Oh well, I can always point to my chart and say 'look, it's not my fault!'.
> July 22 - a cancerian. Pisces moon and Aires rising. Double whammy with sensitivity and Aires for my warrior!
> I'll see you over at grief.
> katia
Posted by BarbaraCat on July 31, 2004, at 15:33:11
In reply to Re: Lamenting your losses-BarbaraCat Katia, posted by malthus on July 31, 2004, at 12:17:23
Thanks so much, Malthus, and sorry about your Winston Kitty. It's amazing the pure love these critters inspire. Thanks for the Emily Dickenson quote. I love her. Here's one that I think is by Oscar Wilde:
"Heaven would not a heaven be,
were my cats not there to welcome me".This always gives me great comfort.
Now, as far as your meds, 75mg of Lamictal can be a perfectly fine dose. It sustained me for almost a year. Then my Mom died after being hit by a car while out walking and it unhinged me. Raising the Lam did nothing but make me agitated, something like what Katia experienced. Then I got a pre-rash condition when I raised it to 150mg. That 'therapeutic dose' is just too much for some people. What finally helped more than anything to pull me out of a very dark place was nortryptaline. A great AD, I just wish it didn't have the annoying dry mouth and eyes side effect, which became too much for me. Now I'm just on lithium and St. John's Wort for the depression and it's been pretty effective.
Your pdoc sounds rather anal about sleep meds, but maybe she's had some experiences with patients that have made her cautious. It's always best to go to sleep on your own, so do whatever it takes. But you might truly have a sleep disorder which goes hand in hand with bipolar disorder. If you need a sleeper, then that's the way it is and maybe find a new pdoc. You need to sleep. If you haven't given benedryl (50 or 100mg) a try, consider it. It's over the counter and can be very effective. - Barbara
> I'm so sorry I didn't say anything in my last post but I am sad about the loss of your pets. I know first-hand how difficult this is; had to have my Winston Cat put to sleep in my arms; I couldn't get out of bed for a week and mourned for a long time after.
>
> "Parting is all we know of heaven and all we need of hell." Emily Dickinson
>
> You are both in my thoughts. Best, Malthus
Posted by malthus on July 31, 2004, at 19:37:04
In reply to Re: Lamenting your losses-BarbaraCat Katia » malthus, posted by BarbaraCat on July 31, 2004, at 15:33:11
the Oscar Wilde poem is beautiful. I wrote it down. I'm truly sorry about your mother. That must have been so awful for you. You are very strong which inspires me.
For the meds I'm going to try the benedryl (sp?) as you suggested and hope it helps with the sleep. I too am terrified about "The Rash". Dr. G made me go to a dermatologist and ask that she (the dermatologist) be on board should I get this. The dermatologist had not heard of SJS but looked it up in her "big book" and showed me these awful pictures of SJS victims which scared the daylights out of me. (This was back in December '03 and I went back to her and told Dr. G. I was too scared). Finally she really wanted to put me on a mood disorder drug because of the resistant treatment depression. By this time I had gained almost 20 lbs. in 9 months due to Xyprexa and Seroquel. She talked about Lithium but didn't want to go this route as it can cause weight gain.
Sorry to ramble on. I appreciate your advice and will get some benedryl tomorrow.
Best,
Malthus
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.