![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 20 to 44 of 212. Go back in thread:
Posted by qbsbrown on July 25, 2009, at 15:55:00
In reply to Re: I took some depakote Scott, posted by qbsbrown on July 25, 2009, at 15:48:35
Oh, and has taken away a LOT of paranoia. I would be too affraid to eat certain/many foods that i was having adverse effects to, so have been avoiding many things out of paranoia.
Today, I just saw something, and was hungry, so ate it w/o fear.
A great feeling!
Brian
Posted by qbsbrown on July 25, 2009, at 17:26:23
In reply to Re: I took some depakote Scott, posted by qbsbrown on July 25, 2009, at 15:55:00
Except that i still had an allergic reaction to the food. There are only a handful of foods i can tolerate. Damn! A little set back.
Crap,
Brian
Posted by qbsbrown on July 27, 2009, at 1:39:24
In reply to Re: I took some depakote Scott, posted by qbsbrown on July 25, 2009, at 17:26:23
Ok, 2 doses and I'm done. Like I said , SO chemically sensitive. Never had such horrific depression and dysphoria, almost felt like a nervous breakdown at the dog park, everything looked depressing and horrific.
What is your opinion on a phenobarbital detox? I know it was banned in the UK and deemed "barbaric", but is still commonly used in the US. I think dragging this out for a year would be more barbaric.
Then again, I've been reading my old posts here, and back in '04 I was begging to get off klonopin, and was talking about how chemically sensitive i was/am, and couldn't tolerate them.
So not sure if the gabitril and/or pheno would work
Regards,
Brian
Posted by SLS on July 27, 2009, at 6:02:33
In reply to Depakote a no go Scott, posted by qbsbrown on July 27, 2009, at 1:39:24
> Ok, 2 doses and I'm done.
Crap.
What about Neurontin? It seems to be effective for alcohol withdrawal at higher dosages. I'll have to look into phenytoin.
> Like I said , SO chemically sensitive. Never had such horrific depression and dysphoria, almost felt like a nervous breakdown at the dog park, everything looked depressing and horrific.
Wow. That is worse than I thought would occur so quickly at a low dosage.
> What is your opinion on a phenobarbital detox?
Would you enter a clinical facility to try it? I really don't know anything about it. However, if it is standard practice with a high success rate, perhaps it is time to stop playing with the other anticonvulsants.
> I know it was banned in the UK and deemed "barbaric", but is still commonly used in the US. I think dragging this out for a year would be more barbaric.
>
> Then again, I've been reading my old posts here, and back in '04 I was begging to get off klonopin, and was talking about how chemically sensitive i was/am, and couldn't tolerate them.
>
> So not sure if the gabitril and/or pheno would workTopamax (topiramate), too.
I imagine you would know quickly whether a drug would work or not. I doubt you would have to wait much more than a week to determine efficacy.
- Scott
Posted by qbsbrown on July 27, 2009, at 14:16:27
In reply to Re: Depakote a no go Scott, posted by SLS on July 27, 2009, at 6:02:33
> What about Neurontin? It seems to be effective for alcohol withdrawal at higher dosages. I'll have to look into phenytoin.
>
Neurontin has given me random suicidal ideology out of nowhere 2 times before. Like i was perfectly fine, then i'd be laying in bed, imagining me going to walmart and buying a gun. SCARY crap. And I'm not a suicidal guy. Like i said, i have bad adverse reactions to all meds> > What is your opinion on a phenobarbital detox?
>
Not sure about the pheno detox. I've never tried a barbituate before, but yeah, i hate the anticonvulsants.
> Topamax (topiramate), too.
>
> http://www.ncbi.nlm.nih.gov/pubmed/12858324?ordinalpos=13&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
>
> http://www.ncbi.nlm.nih.gov/pubmed/17071548?ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
>
> http://www.ncbi.nlm.nih.gov/pubmed/15510234?ordinalpos=12&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
>
> I imagine you would know quickly whether a drug would work or not. I doubt you would have to wait much more than a week to determine efficacy.Interesting on the topamax. All that i remember it doing was giving me derealization, and making me stupid. Took a couple of doses and threw it away like most meds, lol.
Let me know if you find any decent info on the phenobarbitol detox, or the flumenzil.
Thanks for the help. Sadly it looks, that the only way out of this, is through.
Regards,
Brian
Posted by qbsbrown on July 27, 2009, at 14:28:21
In reply to Re: Depakote a no go Scott, posted by SLS on July 27, 2009, at 6:02:33
I remember asking the doc for neurontin in '05 for benzo wd. And felt better immediately. Can't remember why i threw it away so fast, lol.
Maybe a try, but the suicidal ideology scares me. First time i had ever envisioned or pictured me carrying it out. And i wasn't not, or am not even suicidal, lol!
Posted by qbsbrown on July 27, 2009, at 14:31:29
In reply to Re: Depakote a no go Scott, posted by qbsbrown on July 27, 2009, at 14:28:21
tegretol (carbamazepine) seems to be option number 1. I'm imagining that i'd have the same reaction to it as trileptal? Then again, i had exact opposite reactions between celexa and lexapro
Posted by SLS on July 27, 2009, at 15:29:06
In reply to Re: Depakote a no go Scott, posted by qbsbrown on July 27, 2009, at 14:31:29
> tegretol (carbamazepine) seems to be option number 1. I'm imagining that i'd have the same reaction to it as trileptal? Then again, i had exact opposite reactions between celexa and lexapro
I like the Tegretol option. It is not activating as is Trileptal, so perhaps you won't develop agitation or other psychiatric side effects.
- Scott
Posted by qbsbrown on July 27, 2009, at 16:37:15
In reply to Re: Depakote a no go Scott, posted by SLS on July 27, 2009, at 15:29:06
So you think that Tegretol would not act the same as Trileptal? Which was basically inducing a rapid cycling bipolar type symptoms in me.
Or would you try Gabitril first (given my reaction to trileptal)?
Dr. Heather Aston, who doesn't advocate using meds for withdrawal, except an antidepressant if suicidal says, "There have been some reports that gabapentin (Neurontin), tiagabine (Gabitril) and possibly pregabalin (yet to be licensed) help with sleep and anxiety in withdrawal. However, there have been no controlled trials and it is not clear whether these drugs themselves cause withdrawal effects. In practice additional drugs are seldom needed with very slow benzodiazepine tapering. Only in special situations there might be a place for an antidepressant, beta blocker, sedative antihistamine or anticonvulsant.
PS- Are there any good online pharmacies w/ no prescription required?
Brian
Posted by qbsbrown on July 27, 2009, at 17:43:29
In reply to Re: Depakote a no go Scott, posted by qbsbrown on July 27, 2009, at 16:37:15
It seems that my gaba is so messed up, that anything that touches is, causes great depression, including depakote, niacinimide, and other supplements that effect gaba.
I don't know, perhaps one could have the same effect as depakote that i was able to get out of the house and do things (totally agoraphobic), but just not make me see horrible ugly things, and depressing thoughts.
Trileptal made me see ugly things, and depressive thoughts, hence me worrying about tegretol.
Regards,
Brian
Posted by qbsbrown on July 27, 2009, at 18:31:51
In reply to Scott, which one acts on GABA the least, posted by qbsbrown on July 27, 2009, at 17:43:29
It says that Gabitril binds to histamine H1 and serotonin 5HT1B,
Anything serotonic, even a small amount of 5htp makes me feel depressed, and anything that touches histamine makes me feel super groggy and hung over.
Am I screwed? LOL. Seems that anything that I try just makes me worse. But I feel like I'm floating, on an acid/lsd trip, and that anticonvulsants make me feel more grounded, connected to the earth.
I can't even drive right now. My friend needed help putting a bed together, which there is no way my withdrawal mind/brain can comprehend how to do so. On 2 doses of depakote, i felt grounded, could remember some portuguese, paranoia lessened, and i told my friend to have me put the bed together before it wore off, lol. But the depression, sights, images were just too much to bear.
Posted by SLS on July 27, 2009, at 19:09:04
In reply to Gabitril, posted by qbsbrown on July 27, 2009, at 18:31:51
Gabitril (tiagabine) is a GABA reuptake inhibitor. That is not to say that it wouldn't be an ideal drug for you, but if you wish to avoid GABAergic drugs, Gabatril would be one to stay away from.
Topamax and Phenobarbital both modulate GABA receptors, but don't necessarily stimulate them directly. Topamax is looking more and more attractive. It works primarily by blocking glutamate receptors (AMPA/Kainate). Glutamate neurons are probably kindled in your condition. Starting at a low dosage and working up to 100mg gradually should minimize cognitive disturbances. This was my experience on two occasions.
- Scott
Posted by qbsbrown on July 27, 2009, at 20:08:56
In reply to Re: Gabitril, posted by SLS on July 27, 2009, at 19:09:04
> Gabitril (tiagabine) is a GABA reuptake inhibitor. That is not to say that it wouldn't be an ideal drug for you, but if you wish to avoid GABAergic drugs, Gabatril would be one to stay away from.
>
> Topamax and Phenobarbital both modulate GABA receptors, but don't necessarily stimulate them directly. Topamax is looking more and more attractive. It works primarily by blocking glutamate receptors (AMPA/Kainate). Glutamate neurons are probably kindled in your condition. Starting at a low dosage and working up to 100mg gradually should minimize cognitive disturbances. This was my experience on two occasions.
>
>
> - ScottWell, sadly, I think it's going to take a antiseizure med to get through this. The withdrawal almost feels like being on acid/high/lsd, that I'm floating and not connected to the earth. A strange feeling needless to say.
The anticonvulsants were the only thing to make me feel "grounded", probably because I was in benzo wd/tolerance/interdose for the past 6 years. And some also cleared up derealization, namely depakote and trileptal.
And the racing thoughts were/have been so bad from the wd, that I haven't been able to even focus or watch the tv in years. The only time i could focus on the tv was w/ trileptal, or an insane dose of depakote. And trileptal, I got naturally tired at night for the first time in years and years. Or even to drive w/ the racing thoughts, would have to be a serious dose of zyprexa (30mgs), or a huge dose of depakote (2000mgs). Thought I was bipolar for a couple of years, come to find out from docs, it was just benzo wd the whole time.But like I had said, the trileptal was inducing rapid cycling type of symptoms, and even ugly depressing thoughts like i had mentioned, even at the starting dose of 300mgs 2 times a day, even though it got me out and doing things.
Funny, that 3 years ago, i was doing a valium taper as well. I added 150mgs of trileptal 2 times a day, and all of the sudden i was out the door doing many things, although things still seemed a little weird and not right (but not ultra depressing looking or feeling, just odd), but i was easily cutting my dose.
I was trying 150mg doses the other week, and it was just making me worse.
So obviously it's going to be a very small dose of whatever I take if I do so.
I would go for topamax, but i've taken it before, and gives me bad derealization and makes me dumber than a sack of rocks.
I think that you might be right about the Tegretol. It seems like the most used for benzo wd, and that it promotes better sleep and antianxiety effects than depakote.
I see that the starting dose it 200mgs 2 times a day. So w/ me, I'd have to try about half of that. Does that sound about accurate?
Much regards,
Brian
Posted by qbsbrown on July 27, 2009, at 21:09:58
In reply to Re: Gabitril, posted by qbsbrown on July 27, 2009, at 20:08:56
Well, another med,, another trial. Man, I'm just looking for any kind of break. I thought that I had it for a sec w/ depakote.
Everything has made it worse. All vitamins, minerals, supps, herbs, and meds.
Given that I have adverse reactions to all meds (antidepressants made me depressed, bipolar meds induced bipolar type symptoms, total paradox, but i hear the same from many in wd), I would not expect anything different from this. I guess there just has to be a tolerable amount of what I'm willing to put up with. But what i felt and saw and experienced w/ even 500mg depakote, was not worth it.
Do you think 100mg 2 times a day? Or for me, given my sensitivity, even 50mgs 2 times a day?
Reading this part of it kinda worried me, and made me wonder why/how it has been successful sometimes in benzo wd.
"Carbamazepine increases the activity of enzyme systems in the liver, so that the liver chews up medications more quickly. This generally reduces the blood levels of almost any medication metabolized in the liver (most medications are). Thus carbamazepine has multiple potential interactions with other common medications, but generally it lowers their levels. So the risk to watch for is loss of effectiveness of a medication that was previously working"
So it could potentially be lowering levels of valium quicker?
What a trip these drugs are man. I just want off, lol.
Regards,
Brian
Posted by qbsbrown on July 27, 2009, at 22:25:48
In reply to Well, doc approved Tegretol now, posted by qbsbrown on July 27, 2009, at 21:09:58
This probably feels worse than my cold turkey 3 years ago. It's hard to see the point of going extremely slow to me.
With you theory of "kindling", which seems to be accurate, doesn't there have to be some type of intervention?
This reminds me of cold turkey that i tried 3 years ago, but worse. I
went cold turkey for 3 weeks, just psychotic. I couldn't tell you my
name or address. I can't tell you my new roomies address to save my life
lol. Sometimes I forget her name and who i'm living with. Same with cold turkey, my girlfriend would walk into the store that i was working at, and one time i honestly remember it take me a couple of minutes to register who she was. Then i couldnt sleep and was going crazy, and was sprinting around the streets of portland in the middle of the night. Somehow in that state, i was able to drive with her, and even
drive a little, for 12 hours once. I can barely go for a car ride now.Hard for me to envision doing this for a long time, w/o doing/trying a rapid detox, which seem to be tegretol, or phenobarbitol.
But I understand the risk of seizures, which the anitseizure would/could prevent, and the risk of psychosis, which i feel very close to. So that's the main fear.
And i know that they say that benzo cold turkey and rapid detox can be similar to PTSD, which I have done 2 times, and that even regular going through benzo wd can be similar to PTSD.
So it's tough to gauge what and how to wager
Regards,
Brian
Posted by qbsbrown on July 28, 2009, at 0:35:57
In reply to Well, doc approved Tegretol now, posted by qbsbrown on July 27, 2009, at 21:09:58
Do you think it matters between generic tegretol and tegretol xr?
Thanks,
Brian
Posted by qbsbrown on July 28, 2009, at 1:03:49
In reply to Re: Well, doc approved Tegretol now, posted by qbsbrown on July 28, 2009, at 0:35:57
Tegretol generic is dirt cheap, like 120 200mg pills for 13 dollars. 120 200mg pills of XR is about 100 dollars.
Is it worth the difference? I do have probs w/ peaks and valleys w/ meds, and it looks like tegretol is taken 3-4 times per day. I would have to take it 4 times a day, as i am a rapid metabolizer.
Regards,
Brian
Posted by qbsbrown on July 28, 2009, at 13:09:39
In reply to Re: Well, doc approved Tegretol now, posted by qbsbrown on July 28, 2009, at 1:03:49
Can you get away with 2 doses? Or does it need to be more? I'm worried about the peaks and valleys.
Worried about it cause it's related to trileptal (dysphoric thoughts images etc), related to tricyclic antidepressant (ugly thoughts images etc).
If it help the withdrawal, and even though it might allow me to leave the house, perhaps it's best that i stay in so i don't have to expose myself to seeing and thinking ugly things.
This was the same w/ every drug, I wouldn't imagine that it'd be different for this one.
One good thing that i might have going, is that it is a drug that i've never taken before (shocker), so it has a greater chance of helping, correct?
All the others i have tried or used multiple times, and they seem to work less and less every time, and have more adverse effects.
Hope you can guide me with the dosing.
Regards,
Brian
Posted by SLS on July 28, 2009, at 20:45:36
In reply to Tegretol dosing Scott?, posted by qbsbrown on July 28, 2009, at 13:09:39
> Worried about it cause it's related to trileptal (dysphoric thoughts images etc), related to tricyclic antidepressant (ugly thoughts images etc).
Just because a drug is chemically related to another compound does not mean that they both have the same pharmacology.
> Hope you can guide me with the dosing.As far as dosage is concerned, your guess is as good as mine. 400mg maybe?
- Scott
Posted by qbsbrown on July 28, 2009, at 21:11:35
In reply to Re: Tegretol dosing Scott? » qbsbrown, posted by SLS on July 28, 2009, at 20:45:36
> > Worried about it cause it's related to trileptal (dysphoric thoughts images etc), related to tricyclic antidepressant (ugly thoughts images etc).
>
> Just because a drug is chemically related to another compound does not mean that they both have the same pharmacology.
>
> > Hope you can guide me with the dosing.
>
> As far as dosage is concerned, your guess is as good as mine. 400mg maybe?
>
>
> - Scott400 looks to be the starting dose for most. And given my reaction to only 500mgs on depakote, and my bad reactions to 150mgs of trileptal, that maybe I should only try half? 150-200.
Are/were we close with the depakote or another anticonvulsant? As sleep was good the first night (bad the second), improved mood, was able to leave the apt, less paranoia, better cognition, just serious dysphoria. But ended up making wd symptoms worse.
This thing is getting bad, to where i can't leave the apartment (I'm home alone til roomie gets home), and just feel psychotic 24/7, and do weird obsessive rituals.
Do most meds not work as well the second time around, or the more often you go back to them? I've taken trileptal and depakote many times, and had worse reactions every time i go back to them. My only hope with tegretol is that i have never used it before, and is the most common med to assist with wd, and that is better for anxiety and sleep.
I'm at a loss man, I don't know what else I can do.
If you had this kind of kindling going on, would you keep on trying other anticonvulsants til something helped a little? Does kindling usually require anticonvulsants?
It's tough, im looking for some relief, but ever time i try something, it seems to make me worse. And that goes for all meds/vitamins/supps/herbs
Regards,
Brian
Posted by qbsbrown on July 28, 2009, at 21:23:56
In reply to Re: Tegretol dosing Scott?, posted by qbsbrown on July 28, 2009, at 21:11:35
Or perhaps try 300mgs, and dose 100mgs 3 times daily w/ the diazepam (I am afraid that it lowers the diazepam blood levels). I would pay for anything for any stress, anxiety, and/or insomnia relief.
But seriously when i was on trileptal 900mgs and was able to drop 30mgs to 10mgs in 10 days w/ no problem, until i cold turkeyed the trileptal, then went back to 30mgs. Is that some serious kindling going on?
My brain is basically petrified at this point, in shock and trauma, and adding chemicals is probably going to make me worse initially, do i need to continue the med even though it might be bothering me?
Back in April, I wanted to attend a zen retreat, but showed up only back on the diazepam, and i was stuck like a deer in the headlights, frozen in fear.
Then i took 300mgs of trileptal, and all of the sudden i was able to attend, and sit at the front of the class. Such a dramatic difference. Although it allowed me to do that, i only took 3 doses and threw it away. I/my brain just hated the feeling of being drugged, when i was my mission to get away from that feeling.
I tried trileptal 2 other times during the taper, and it just made me worse.
But perhaps feeling a little drugged might be a necissary evil for now.
We'll see.
Regards,
Brian
Posted by qbsbrown on July 29, 2009, at 5:40:25
In reply to Re: Tegretol dosing Scott?, posted by qbsbrown on July 28, 2009, at 21:23:56
I took the first dose of 100mgs tegretol around 10pm. Tried to go to bed at 12, and am now up at 3am, sweating more profusely than usual.
I guess this is to be expected, corrrect? They all aggrivate at first.
The same thing happened with me and trileptal 3 months ago, and i was able to attend my zen center and able to stand the stress of being there the following day. I just quit it after 3 doses, when maybe it could have proven effective.
So I need to continue with it correct?
Might be a week adjustment? I was thinking about 100mgs 3 times a day, dosing at same time as diazepam.
Regards,
Brian
Posted by SLS on July 29, 2009, at 5:58:48
In reply to first dose of Tegretol Scott, posted by qbsbrown on July 29, 2009, at 5:40:25
> So I need to continue with it correct?
As you begin to feel that your options are becoming fewer, I suppose that it becomes more important to give things a fair trial. I wish I could guarantee that things will work out with the Tegretol, even though you might have to endure some startup side effects.
> Might be a week adjustment? I was thinking about 100mgs 3 times a day, dosing at same time as diazepam.That sounds reasonable to me. Start low and increase gradually. Just know that you can go up to 1200mg if need be. I can't see needing more than 600mg, though, but this is your experiment to discover the right dosage.
If it works, it will be important to taper the Tegretol slowly so that you don't trigger an already kindled system. But you can cross that bridge when you come to it.
- Scott
Posted by qbsbrown on July 29, 2009, at 6:09:40
In reply to Re: first dose of Tegretol Scott, posted by SLS on July 29, 2009, at 5:58:48
Yeah, I read that they usually used about 200-800mgs of carbamazapine.
A little chest tightness is a little concerning. I've had the heart palpitations during the withdrawal before, but not for a long time.
I hope that it's ok to do this unsupervised.
But like you said, I haven't given anything a fair trial. So we'll see
Posted by qbsbrown on July 29, 2009, at 6:37:00
In reply to Re: first dose of Tegretol Scott, posted by qbsbrown on July 29, 2009, at 6:09:40
Why do you think that none of the benzo "experts" such as Ashton, Peart, or Ray Nimmo talk about kindling, and/or promote the use of anticonvulsants (although Ashton had said that Gabitril might be promising for it's anti anxiety and sleep properties)?
But the published medical studies I've read on kindling, and your theory, make a lot of sense to me, and seem to be accurate.
It would basically be heresy to promote or advocate the use of another medication on a benzo forum to get off a benzo.
That adding any med to an already damaged and compromised CNS would only further hurt it.Some will kick you off if you talk about using a med, or even a vitamin/supplement/herb to assist in coming off of them.
Most are pretty fringe groups/forums it seems, and are extremely anti-psychiatry.
So it's tough to know who to believe. My doc thought that if I was having such a hard time coming down and off, that it would be worth a shot.
Regards,
Brian
Go forward in thread:
Psycho-Babble Withdrawal | 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.