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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 28 to 52 of 71. Go back in thread:
Posted by Dinah on May 27, 2013, at 9:40:05
In reply to Just trying to find the right meds for me, posted by Diana1981 on May 27, 2013, at 9:09:38
Have you tried lower doseages? I was hit hard by postpartum depression/agitation. I know how awful it can be.
I've found my successful combo in low dose Risperdal as needed for acute agitation or obsessive thinking - a few times a month - and daily low dose Lamictal for mood stabilizing and migraine prophylaxis.
I also take Provigil for a sleep disorder, but I'm not sure if that is related.
Are you getting enough sleep and exercise? Do you have good support with your daughter? It's hard to remember to take care of ourselves when there is a toddler in the house. Are you currently in therapy? Therapy was very helpful for me. Bipolar is a medical illness, but stress can definitely exacerbate it.
Do you know why your doctor is reluctant to try Lithium? Are you bipolar I or II? Or as I am, more like III or bipolarish or cyclothymic?
Could any of your current medications be causing agitation? I was put on Luvox postpartum, and while I did see benefits from it, I now think it caused some very low level agitation that was not at all good for me.
Posted by Dinah on May 27, 2013, at 9:46:35
In reply to Re: Just trying to find the right meds for me » Diana1981, posted by Dinah on May 27, 2013, at 9:40:05
I think Effexor can be very stimulating. The best of my pdocs thought it was imperative to have a mood stabilizer in similar circumstances.
Posted by Diana1981 on May 27, 2013, at 10:00:26
In reply to Re: Just trying to find the right meds for me » Diana1981, posted by Dinah on May 27, 2013, at 9:40:05
I am bipolar 2 which is why my dr has not tried lithium. I am very nervous about wt gain. I get very upset and uncomfortable. I do exercise regularly however I have noticed that since being on the Trileptal my motivation and running time have decreased drastically.
Posted by Lou Pilder on May 27, 2013, at 10:03:01
In reply to Just trying to find the right meds for me, posted by Diana1981 on May 27, 2013, at 9:09:38
> I am just tryin to fin the right meds for me. I had my daughter 12 almost 13 months ago. Before my pregnancy however I began to show symptoms of bipolar. They were very intense during my pregnancy an even more intense after she was born. Currently I experience on and off depression and mood swings twice a day. I grow angry and obsessive thinking patterns. I also crave carbs and sugar constantly and when I take my triliptal I tend to obsess about food an eat all day long. Not good. I have tried so many meds an they make me so sleepy. I am just trying to find a way to be healthy again and stable.
D,
You wrote in your original post what could be thought that you were contemplating either to find another drug or stop drugging yourself. But now I see that you are wanting to stop the drugs that you are taking and then try to find the "right drugs". But in another vein, you say that:
[...I am just trying to find a way to be healthy *again* and be stable...]
Now that could mean:
A. you want to go back before you took the drugs when you were healthy and stable
B. the pregnancy has caused the depression and swings
C. the symptoms were there before the pregnancy and exhibited magnification during pregnancy
D. something else.
Now I don't claim to be clairvoyant, so I can't know what's ahead. But being that you bring in the childbirth and cravings, that can lend some facts that could keep you from being dead. Those facts lead me to believe that the drugs that you are taking could be the culprit. I base this on a wide-verity of knowledge concerning the chemicals in the drugs and my study of {nerve agents} of which a lot of what I need to post here is prohibited to me by Mr Hsiung. You see, the literature states that the mechanism of action of these drugs is unknown. But it is known how the chemicals can cause death in combination.
Now if you want to find the right drug, if there is one, could you not die from the attempts with drugs before you found it? Could you not get addicted along the way? And could you not then have to take the drug for the rest of your life and get tardive dyskinesia or diabetes or psychosis or destruction and loss of your sexuality and other dehumanizing life-ruining conditions from the drug? But what if you could go back to the green fields, that you used to know, where there were flowers kissed by the sun and rivers there to run, and no drug to be scared of being killed by?
Lou
Posted by Dinah on May 27, 2013, at 10:19:35
In reply to Re: Just trying to find the right meds for me, posted by Diana1981 on May 27, 2013, at 10:00:26
It's all a tradeoff.
The best of my pdocs said to me "There are side effects of medications. There are side effects of not taking medications. It's up to you which side effects you prefer."
You can try to get your stress level down as much as possible. That may help without unpleasant side effects.
But medications are not all that targeted in their action. Effexor works on depression and motivation and energy. But it might overshoot that energy goal and bring you to anxiety and agitation. A mood stabilizer might be good for mood volatility, but cost something (depending on the mood stabilizer) in energy or urge to eat. An AAP can be fabulous for anxiety control, but taken regularly it does have long and short term side effects.
What did Lamictal do to you? I've found it to be a medication with few side effects, though not particularly dramatic in primary effects either.
Are you at the lowest effective dose on your medications? Trying to find that sweet spot might be as helpful as trying new medications.
Posted by Dinah on May 27, 2013, at 10:28:21
In reply to Re: Just trying to find the right meds for me » Diana1981, posted by Dinah on May 27, 2013, at 10:19:35
For example, I'm willing to accept whatever risk comes with my as-needed Risperdal use. It's *that* effective. My life has changed because of it.
I'm not saying that this is a side effect of Risperdal, but if someone told me it was, I'd say...
A few years off my life? Fine. It will be a life worth living.
Posted by Emme_V2 on May 27, 2013, at 10:39:50
In reply to Re: Just trying to find the right meds for me » Diana1981, posted by Dinah on May 27, 2013, at 10:19:35
> It's all a tradeoff.
>
> The best of my pdocs said to me "There are side effects of medications. There are side effects of not taking medications. It's up to you which side effects you prefer."
>
> You can try to get your stress level down as much as possible. That may help without unpleasant side effects.
>
> But medications are not all that targeted in their action. Effexor works on depression and motivation and energy. But it might overshoot that energy goal and bring you to anxiety and agitation. A mood stabilizer might be good for mood volatility, but cost something (depending on the mood stabilizer) in energy or urge to eat. An AAP can be fabulous for anxiety control, but taken regularly it does have long and short term side effects.
>
> What did Lamictal do to you? I've found it to be a medication with few side effects, though not particularly dramatic in primary effects either.
>
> Are you at the lowest effective dose on your medications? Trying to find that sweet spot might be as helpful as trying new medications.Dinah,
Those are very wise words.
I totally agree, dosing is so important. For people who are very sensitive to medications, therapeutic doses can be surprisingly low, and it can help alleviate side effects if you find the minimum effective dose.
emme
Posted by Phillipa on May 27, 2013, at 11:34:59
In reply to Lou's warning and reply- » SLS, posted by Lou Pilder on May 27, 2013, at 5:10:49
Lou this site seems to be from the Washington State patrol. Is it used for impaired drivers?
Posted by ed_uk2010 on May 27, 2013, at 13:03:50
In reply to Re: At a dead end- stop meds or switch. » ed_uk2010, posted by SLS on May 27, 2013, at 7:07:25
> Hi Ed.
>
> If you notice, I try to make a habit of resetting the posting subject line to reflect the theme of the thread whenever it is deleted and replaced by only the name of the respondent. I hope that doing this helps to prevent the chronic hijacking of threads and maintain the integrity of the forum. Otherwise, the board really looks ugly and unappealing when half of the posts contain only the name of the same one poster.
>
>
> - ScottGood idea Scott. It makes a difference.
Posted by ed_uk2010 on May 27, 2013, at 13:17:06
In reply to correction- Lou's reply-drugs.com, posted by Lou Pilder on May 27, 2013, at 8:56:25
>Here is a link from drugs.com showing the interactions between Trileptal and Effexor.
Unfortunately, this interaction checker is not accurate. There are no reports in the medical literature of venlafaxine + oxcarbazepine causing respiratory depression. These particular meds are not respiratory depressants, either alone or together.
Beware of using the drugs.com interaction checker. Instead, use a reliable source such as the textbook 'Stockley's Drug Interactions', which is written by experts and uses a huge range of case reports and studies from the published medical literature.
Posted by Lou Pilder on May 27, 2013, at 15:28:47
In reply to Online automatic drug interaction checkers » Lou Pilder, posted by ed_uk2010 on May 27, 2013, at 13:17:06
> >Here is a link from drugs.com showing the interactions between Trileptal and Effexor.
>
> Unfortunately, this interaction checker is not accurate. There are no reports in the medical literature of venlafaxine + oxcarbazepine causing respiratory depression. These particular meds are not respiratory depressants, either alone or together.
>
> Beware of using the drugs.com interaction checker. Instead, use a reliable source such as the textbook 'Stockley's Drug Interactions', which is written by experts and uses a huge range of case reports and studies from the published medical literature.
>
> ed,
When no interaction is listed, that does not mean that there can not be an interaction.
In the case here, Trileptal is an anticonvulsant and has sedation listed as a consequence of taking the drug. Effexor has sedation also listed.
Drugs that sedate depress the central nervous system. These two drugs are CNS depressants. Reactions that are exponential rather than arithmetic can happen when more than one CNS depressant is taken. The danger is sudden death via cardiac or respiratory depression.
The drugs.com site even states that they do not have reports of events from combining the drugs, but they state that CNS depression can happen when the two drugs are combined. It may be that prescribers know that combining CNS depressants could cause death and do not prescribe them together. Another thought here is that Trileptal is a chemical modification of another anticonvulsant.
DRugs.com said what it said and I accept that the two drugs are CNS depressants. I have never seen the drugs profiled stating that they do not cause sedation, which is a characteristic of a depressant. I have also studied the chemical composition of the drugs and sedation can come from those chemicals.
Lou
Posted by vbs on May 27, 2013, at 16:44:30
In reply to Lou's response- » ed_uk2010, posted by Lou Pilder on May 27, 2013, at 15:28:47
Lou, antidepressant drugs are not CNS depressants. You've lost all credibility with me. Stop your distorted campaign of misinformation.
Posted by diana1981 on May 27, 2013, at 18:31:49
In reply to Re: Just trying to find the right meds for me » Dinah, posted by Emme_V2 on May 27, 2013, at 10:39:50
Thank you Dinah and Emme
The Lamictal had made me too drowsy to even stay on. Space cadet.
I am just so distraught over this situation. I don't want the anger fits but on the other hand I don't want the falling asleep mid day and jaw clenching and overeating.
Its very stressful.
Diana
Posted by Lou Pilder on May 28, 2013, at 7:24:31
In reply to Re: Lou's response-uh oh my crap detector went off » Lou Pilder, posted by vbs on May 27, 2013, at 16:44:30
> Lou, antidepressant drugs are not CNS depressants. You've lost all credibility with me. Stop your distorted campaign of misinformation.
Friends,
Be not deceived. The two drugs in question here taken together could cause death. They are both CNS depressants, for they cause sedation and drowsiness. And taken together causes exponential effects which could lead to death by heart or respiratory depression.
Many of you already know from reading on the admin board here where the post that I am responding to here (redacted by respondent). But it is much more than that, for deaths could occur if what is cast at me here is allowed to be thought to be true. People could die as a result of thinking that one could take an anti seizure drug together with Effexor. You see, I am trying to save lives here by posting educational material that could mark the difference between you or your child or other loved one being a live person or a corpse.
Here is a link that shows that Trileptal is a CNS depressant. And then I will show you Effexor as also a CNS depressant
Lou
http://www.speedyhealth.com/drug/trileptal.html
Posted by SLS on May 28, 2013, at 9:48:53
In reply to Lou's response-wydudhaheethunrayg » vbs, posted by Lou Pilder on May 28, 2013, at 7:24:31
I felt that it was important to reset the subject line in this instance.
- Scott
Posted by SLS on May 28, 2013, at 9:58:33
In reply to Re: Just trying to find the right meds for me, posted by diana1981 on May 27, 2013, at 18:31:49
> Thank you Dinah and Emme
>
> The Lamictal had made me too drowsy to even stay on. Space cadet.How did you go about beginning Lamictal treatment? At what dosage did you begin to experience sedation and sleepiness?
I hope that you can maintain your positive and constructive attitude, despite your current disappointments. It can take quite awhile to discover a treatment that works. I hope that you find it helpful to post here, despite the occasional presence of extremism.
- Scott
Posted by Willful on May 28, 2013, at 10:16:08
In reply to Lou's response-wydudhaheethunrayg » vbs, posted by Lou Pilder on May 28, 2013, at 7:24:31
I just wanted to note that on this logic, it's quite possible to argue that someone should never leave the house. Leaving the house can lead to death-- for example, by being run over by a bus, being hit by lightening, or tripping and hitting one's head on the sidewalk..
Everything you can do- including leaving one's house in the morning-- involves weighing risks and benefits-- and the likelihood of them. Clearly, all actions have risks-- and therefore if you're to avoid any risks, no matter how great the benefit-- and no matter how unlikely-- you would need not to get out of bed in the morning. Dire events can happen even in your apartment-- much less on the street.
Most of us, however, make the choice to take certain risks in the belief that it's worth that risk, even if it's a small risk of a dire event-- because the belief in the probability of a real benefit is much more probable. Of course, these become complex questions at times.
This is certainly the case with Anti-depressants-- we all know they have risks-- and benefits. Each of us tries to make a rational decision about these. You, Lou, have decided to avoid any even minimal risk -- but most people see benefits that, in various medications, outweigh the risks.. We can share our experiences-- and I assume yours have been very bad-- but I wonder if you realize that most people have a different view of risks-- and therefore that the small chance of death that you're mentioning, while it might-- I emphasize~~~might~~~ be possible-- would be seen in the light of many factors that seem to be missing in your discussions.
Diana seems to have already decided that the risks of some medications are greater than the risks-- and be asking for much more nuanced advice on how to weight specific regimens-- and I think therefore that your interventions- are basically, are not on point.
'X ( action) "can" cause Y (result)' is not an answer. There are so many more elements to be accounted for-- as in the question of whether to leave the house.
Posted by vbs on May 28, 2013, at 11:07:36
In reply to Lou's response-wydudhaheethunrayg » vbs, posted by Lou Pilder on May 28, 2013, at 7:24:31
Lou, I apologize for my previous post. It was a bit abrasive. You're certainly entitled to formulate your own opinions regarding the pharmacology of psychotropic drugs.
Posted by ed_uk2010 on May 28, 2013, at 15:42:44
In reply to Lou's response- » ed_uk2010, posted by Lou Pilder on May 27, 2013, at 15:28:47
>When no interaction is listed, that does not mean that there can not be an interaction.
True.
>In the case here, Trileptal is an anticonvulsant and has sedation listed as a consequence of taking the drug. Effexor has sedation also listed.
Both drugs can cause drowsiness in some patients, no one disputes that. My point is that they do *not* cause respiratory depression.
Posted by Lou Pilder on May 28, 2013, at 16:31:45
In reply to Re: Lou's response- » Lou Pilder, posted by ed_uk2010 on May 28, 2013, at 15:42:44
> >When no interaction is listed, that does not mean that there can not be an interaction.
>
> True.
>
> >In the case here, Trileptal is an anticonvulsant and has sedation listed as a consequence of taking the drug. Effexor has sedation also listed.
>
> Both drugs can cause drowsiness in some patients, no one disputes that. My point is that they do *not* cause respiratory depression.
>ed,
There is a lot that I am not permitted to post here concerning Effexor due to prohibitions posted to me here by Mr Hsiung.
You see, we are talking about taking the two drugs together. It is when they are combined that the sudden death could happen. This is because of properties in the drug Effexor that may not be easily understood.
The drug can induce somnolence and insomnia. I have studied this but can not post what I know about this here. There are a lot of reports available concerning this and one from here over 10 years ago concerning the person falling asleep in the day while on Effexor.
But going ahead anyway, it is when the drug is combined with another drug that can induce somnolence, the exponential aspect of ramping up the {depressive} aspect of the central nervous system happens, and can be to such that failure of the nervous system can happen which causes death.
The chemical in the drug comes from diesel fuel and is highly toxic and is used in insecticides and nerve agents. It is also used as a solvent in industrial applications of which I am prevented from posting about here. You see, Effexor is not a new drug, but a new name for a knock-off of an old drug that I am prevented from posting about here. And the addiction/withdrawal can be horrific to the point where some can not get off of it and have to take it and get the awful effects of log-term use of the drug.
Yet today, I could post how one could overcome addiction to this drug, but I am prevented from posting that here. But thanks for posting to at least bring this aspect of Effexor up so that readers could have more information to make a more informed decision as to take this drug or drug their child in collaboration with a psychiatrist/doctor.
Lou
Posted by polarbear206 on May 28, 2013, at 16:35:42
In reply to Lou's response-wydudhaheethunrayg » vbs, posted by Lou Pilder on May 28, 2013, at 7:24:31
Hey Lou...I've been taking effexor and an antiseizure drug for over 10 years and I'm ALIVE and happy!! You talk about them causing death??? Death is how I felt before being on meds. So analyze that!!
Posted by ed_uk2010 on May 28, 2013, at 17:05:17
In reply to Lou's reply-psykloehex » ed_uk2010, posted by Lou Pilder on May 28, 2013, at 16:31:45
>But going ahead anyway, it is when the drug is combined with another drug that can induce somnolence, the exponential aspect of ramping up the {depressive} aspect of the central nervous system happens, and can be to such that failure of the nervous system can happen which causes death.
True CNS depressants such as the general anesthetics suppress all aspects of CNS function and can cause both respiratory and cardiovascular depression. Neither Effexor nor Trileptal works like this. Both meds have the potential to cause drowsiness in some cases but sleep does not equal respiratory depression. If a person taking a combination of Effexor and Trileptal felt drowsy, they may indeed sleep. It is not appropriate to suggest that this would result in death.
Posted by Lou Pilder on May 28, 2013, at 17:27:48
In reply to Re: Lou's reply-psykloehex » Lou Pilder, posted by ed_uk2010 on May 28, 2013, at 17:05:17
> >But going ahead anyway, it is when the drug is combined with another drug that can induce somnolence, the exponential aspect of ramping up the {depressive} aspect of the central nervous system happens, and can be to such that failure of the nervous system can happen which causes death.
>
> True CNS depressants such as the general anesthetics suppress all aspects of CNS function and can cause both respiratory and cardiovascular depression. Neither Effexor nor Trileptal works like this. Both meds have the potential to cause drowsiness in some cases but sleep does not equal respiratory depression. If a person taking a combination of Effexor and Trileptal felt drowsy, they may indeed sleep. It is not appropriate to suggest that this would result in death.ed,
On the contrary. People die from taking two drugs that can depress the cns. A few months ago, a girl died here . She took a pain pill and later before bed she had a mixed drink. She died in her sleep and the report stated it was the combination of the drug and the alcohol taken that killed her.
The drug Effexor is listed as having the effects exponentially magnified when another drug such as Trileptal is taken together.
Now Effexor by itself has the aspect of addiction/withdrawal. And the drug can increase suicidal and homicidal thinking and when in withdrawal the person could kill themselves and/or others and even commit mass-murder. If someone wants to promote a drug that could cause the taker of the drug to kill themselves, I think that it is even more appropriate to warn those people concerning combining the drug wiht another psychotropic drug that could exponentially increase the aspect of death.
Lou
Posted by Lou Pilder on May 28, 2013, at 17:35:49
In reply to Lou's reply-extudhaen » ed_uk2010, posted by Lou Pilder on May 28, 2013, at 17:27:48
> > >But going ahead anyway, it is when the drug is combined with another drug that can induce somnolence, the exponential aspect of ramping up the {depressive} aspect of the central nervous system happens, and can be to such that failure of the nervous system can happen which causes death.
> >
> > True CNS depressants such as the general anesthetics suppress all aspects of CNS function and can cause both respiratory and cardiovascular depression. Neither Effexor nor Trileptal works like this. Both meds have the potential to cause drowsiness in some cases but sleep does not equal respiratory depression. If a person taking a combination of Effexor and Trileptal felt drowsy, they may indeed sleep. It is not appropriate to suggest that this would result in death.
>
> ed,
> On the contrary. People die from taking two drugs that can depress the cns. A few months ago, a girl died here . She took a pain pill and later before bed she had a mixed drink. She died in her sleep and the report stated it was the combination of the drug and the alcohol taken that killed her.
> The drug Effexor is listed as having the effects exponentially magnified when another drug such as Trileptal is taken together.
> Now Effexor by itself has the aspect of addiction/withdrawal. And the drug can increase suicidal and homicidal thinking and when in withdrawal the person could kill themselves and/or others and even commit mass-murder. If someone wants to promote a drug that could cause the taker of the drug to kill themselves, I think that it is even more appropriate to warn those people concerning combining the drug wiht another psychotropic drug that could exponentially increase the aspect of death.
> Lou
>
Friends,
Now here I a link showing what has been reported when Effexor and alcohol are combined.
Notice the suicide attempts and the completed suicides. I think that readers here should have as amny facts as they can to make an informed decision as to tske these drugs or not.
Lou
http://www.ehealthme.com/drug-interactions/effexor-and-alcohol
Posted by SLS on May 28, 2013, at 18:37:50
In reply to Lou's reply-alcohol-effexor, posted by Lou Pilder on May 28, 2013, at 17:35:49
This was the last subject line posted that referenced content related to this thread.
- Scott
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Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
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