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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Noah on March 30, 2001, at 14:27:07
Like many of you, I have a history that would take pages to tell, so suffice it so say that I have been on drug therapy for depression/anxiety/bipolar for at least 13 years. I have drug soup for blood, and it seems like I am always in that "adjustment" phase of some new medication. I wonder what it's like to be normal...
I have been down to only Depakote and Klonopin for the past year. Depakote for bipolar disorder, and Klonopin for anxiety, which is mostly at night. I was on only 2mg of K per night, which I believe is a relatively small dose, but WHOA--it's a nightmare getting that stuff out of you. I recently had to change doctors because of insurance, and the new one wanted me off Klonopin because of the long-term dependence. The first thing I experienced was sleeplessness through the night, and by day I had constant shortness of breath and panic attacks. That went away after about a week, so the doc gave me Ambien for sleep. That helped my night, except that I was used to being completed knocked out, and started experiencing what felt like watching 5 movies through the night. I can't get the images out of my head in the morning. Also, I have been horribly nauseated every morning, and start by dry-heaving for about 10 minutes after I get up. I can't eat until late in the afternoon each day. I have been losing weight and have hardly any appetite. The nausea symptoms must have been masked by my sedation in the past. I went to see the doc again today, and he suggested that Depakote is causing the nausea. I'm on 3x250mg at night. So he suggested stopping Depakote altogether, and he gave me samples of Zyprexa to try instead. He thinks it will help me sleep, and do away with the morning yukkies too. For the past decade, this will be the LEAST amount of medication I will be on, which is good if it works. I guess I'm skeptical that with my history of depression and everything else, taking only Zyprexa is going to keep me stable. My biggest desire is to get a good night of sleep and not feel nauseated in the morning.
Does anyone know if it's okay to just stop Depakote after a year at that dose? He didn't mention tapering off. Also, has anyone had good success with Zyprexa as a sleep aid, when you're used to 2mg of Klonopin? Also, is Zyprexa a good replacement for Depakote? When I have been off Depakote in the past, I experience mood swings/suicidal thoughts/cry fests, etc.
Posted by Mr. Scott on March 30, 2001, at 15:42:12
In reply to Klonopin nightmare / start Zyprexa / stop Depakote, posted by Noah on March 30, 2001, at 14:27:07
> Like many of you, I have a history that would take pages to tell, so suffice it so say that I have been on drug therapy for depression/anxiety/bipolar for at least 13 years. I have drug soup for blood, and it seems like I am always in that "adjustment" phase of some new medication. I wonder what it's like to be normal...
>
> I have been down to only Depakote and Klonopin for the past year. Depakote for bipolar disorder, and Klonopin for anxiety, which is mostly at night. I was on only 2mg of K per night, which I believe is a relatively small dose, but WHOA--it's a nightmare getting that stuff out of you. I recently had to change doctors because of insurance, and the new one wanted me off Klonopin because of the long-term dependence. The first thing I experienced was sleeplessness through the night, and by day I had constant shortness of breath and panic attacks. That went away after about a week, so the doc gave me Ambien for sleep. That helped my night, except that I was used to being completed knocked out, and started experiencing what felt like watching 5 movies through the night. I can't get the images out of my head in the morning. Also, I have been horribly nauseated every morning, and start by dry-heaving for about 10 minutes after I get up. I can't eat until late in the afternoon each day. I have been losing weight and have hardly any appetite. The nausea symptoms must have been masked by my sedation in the past. I went to see the doc again today, and he suggested that Depakote is causing the nausea. I'm on 3x250mg at night. So he suggested stopping Depakote altogether, and he gave me samples of Zyprexa to try instead. He thinks it will help me sleep, and do away with the morning yukkies too. For the past decade, this will be the LEAST amount of medication I will be on, which is good if it works. I guess I'm skeptical that with my history of depression and everything else, taking only Zyprexa is going to keep me stable. My biggest desire is to get a good night of sleep and not feel nauseated in the morning.
>
> Does anyone know if it's okay to just stop Depakote after a year at that dose? He didn't mention tapering off. Also, has anyone had good success with Zyprexa as a sleep aid, when you're used to 2mg of Klonopin? Also, is Zyprexa a good replacement for Depakote? When I have been off Depakote in the past, I experience mood swings/suicidal thoughts/cry fests, etc.One thing at a time.. You'll get over the klonopin hump in two weeks.. Don't rememeber if you said your tapering or not. If it's too hard try dropping .5 - 1.0 Mg at a time for 2 weeks.. But really the worst thing about this from my point of view is that your insurance company feels it can make these kinds of suggestions to you and your doc.. Their just paper pussing beaurocrats...Who care nothing about you (or me).
Sorry for the diversion, but I would just go slow on Klonopin if it's too bad.. I did it and Xanax before that (even worse)...Alternatively you could switch to a less potent and longer acting Benzo like Tranxene or Valium which are easier to taper over a couple of months.
Sorry for the disrganized answer!!!
Posted by SalArmy4me on March 30, 2001, at 16:44:05
In reply to Klonopin nightmare / start Zyprexa / stop Depakote, posted by Noah on March 30, 2001, at 14:27:07
I like the Zyprexa idea. Seroquel would be my next choice if I were your doctor.
> Like many of you, I have a history that would take pages to tell, so suffice it so say that I have been on drug therapy for depression/anxiety/bipolar for at least 13 years. I have drug soup for blood, and it seems like I am always in that "adjustment" phase of some new medication. I wonder what it's like to be normal...
>
> I have been down to only Depakote and Klonopin for the past year. Depakote for bipolar disorder, and Klonopin for anxiety, which is mostly at night. I was on only 2mg of K per night, which I believe is a relatively small dose, but WHOA--it's a nightmare getting that stuff out of you. I recently had to change doctors because of insurance, and the new one wanted me off Klonopin because of the long-term dependence. The first thing I experienced was sleeplessness through the night, and by day I had constant shortness of breath and panic attacks. That went away after about a week, so the doc gave me Ambien for sleep. That helped my night, except that I was used to being completed knocked out, and started experiencing what felt like watching 5 movies through the night. I can't get the images out of my head in the morning. Also, I have been horribly nauseated every morning, and start by dry-heaving for about 10 minutes after I get up. I can't eat until late in the afternoon each day. I have been losing weight and have hardly any appetite. The nausea symptoms must have been masked by my sedation in the past. I went to see the doc again today, and he suggested that Depakote is causing the nausea. I'm on 3x250mg at night. So he suggested stopping Depakote altogether, and he gave me samples of Zyprexa to try instead. He thinks it will help me sleep, and do away with the morning yukkies too. For the past decade, this will be the LEAST amount of medication I will be on, which is good if it works. I guess I'm skeptical that with my history of depression and everything else, taking only Zyprexa is going to keep me stable. My biggest desire is to get a good night of sleep and not feel nauseated in the morning.
>
> Does anyone know if it's okay to just stop Depakote after a year at that dose? He didn't mention tapering off. Also, has anyone had good success with Zyprexa as a sleep aid, when you're used to 2mg of Klonopin? Also, is Zyprexa a good replacement for Depakote? When I have been off Depakote in the past, I experience mood swings/suicidal thoughts/cry fests, etc.
Posted by Cece on March 30, 2001, at 22:33:02
In reply to Klonopin nightmare / start Zyprexa / stop Depakote, posted by Noah on March 30, 2001, at 14:27:07
Pages and pages here too, with some similarities. I can go down as low as 125mg/ of Depakote (I'm on 250mg/day now), but if I go off completely, I'm a mess. When I lowered my dose- for awhile I was on 100mg/ day, but too much sedation, my pdoc tapered me- long time ago so I forget how slowly.
I would be VERY scared of this doctor myself. Klonopin has to be tapered off very gradually, especially for someone who has been on it for some time. This is psychopharmachology 101. If he is more scared of your dependence than concerned about your well-being, something's screwy in him (I'm not there to sit in the room with him and get the full picture of course). Personally, I think, and my long time pdoc who I just changed from (for mostly financial reasons) thought that addiction/dependence is a non-issue when it comes to mental health. Mood disorders are potentially fatal- how does that stack up against dependence?! I think that it is an old Puritan uptight value that is out of place in modern medicine.
Everyone is different, so don't know if this will help, but the drug that has helped my sleep the most is Nortriptyline. I take only 40mg/day, at night- this is the lowest I can go and still get AD and 'good sleep' effects- if I go lower I'm in a depression pit in about 3 days. I've gotten it to the lowest possible because it gives me weight gain. Neurontin, which I take 300mg, 3Xday (total 900mg), I think has also helped my sleep as well as adding a subtle but important calming element.
I like your term 'drug soup for blood'- me too. This is already a long post, so I'll end here. I'm going to try to find some past posts I've sent about my drug mix and some of these issues- let me know if you are interested.
Good luck- do you have any other choice of pdoc if you decide you don't like this one?
Cece
Posted by ChrisK on March 31, 2001, at 4:41:42
In reply to Klonopin nightmare / start Zyprexa / stop Depakote, posted by Noah on March 30, 2001, at 14:27:07
Zyprexa will be very sedating at first. Eventually you will be able to take it in the evening and sleep well but still be awake during the day. Don't be surprised at the start if you feel very groggy during the day for a couple of weeks. This does end eventually.
Zyprexa does also have some mood stabilizing effects as well as helping with anxietty. As far as using it as your only med for a complicated diagnosis I would guess that you would be better off using it to augment an AD that works for you.
Also. ask your doctor about Geodon. It just came out withing the last 6 weeks and is supposed to have better AD and anti-anxiety effects than Zyprexa. I'm just starting it this week after two years of Zyprexa.
Good Luck,
Chris
Posted by Sulpicia on April 1, 2001, at 22:04:54
In reply to Klonopin nightmare / start Zyprexa / stop Depakote, posted by Noah on March 30, 2001, at 14:27:07
> Hi Noah --
sorry about the way you're feeling. I would immediately get rid of
the doc who stopped the klonopin. He suggests the depakote might be
causing the nausea??? From under what rock did this *doctor* crawl?
For pity's sake you're describing withdrawal symptoms! This should be
done gradually under careful medical supervision because of the risk
of seizures.
So let's see: you walk into the doc stable and OK and leave like this?
Please, please find another doc and consider complaining to higher authority.
I hope you're feeling better soon tho insomnia following withdrawal can last
for a while.
As for the depakote, I don't know. Best place to find out might be an epilepsy
board.
Best,
S.
This is the end of the thread.
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