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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 24 of 24. This is the beginning of the thread.
Posted by MB on August 10, 2001, at 0:52:59
Well, we know I'm a freak, but that's beside the point < g >. Last night, I was having some really bad anxiety/panic (I don't think it warrants the lable "panic attack," but it *did* comprise moderate chest pain, sweating, slow but earth-shattering heart beat, feelings of immanent evil--like the way things look in a nightmare, etc) so I decided to self medicate with the only thing I had. I wanted to down a couple of bottles of wine from the garage, but I've been going to AA for 18 months, and have sworn off the sauce. Anyway, I have some Remeron left. Some of you may remember my Remeron bashing episodes. Anyway, I remembered that in the past, before 15mg of Remeron had put me in "a coma," it had dissipated my anxiety. I decided to take a *VERY SMALL* amount last night (and figured it was "legal" to do even given my recovery program since it is not a scheduled or habit-forming drug). I had remembered from past experiments in anxiolysis that 7.5 mg was too sedating, so I took a 30mg tablet and cut it into 8 pieces (first, both longitudinally and latterally, then I cut each quarter laterally). I took one of the eighths, and scraped about 2/3 of the compressed powder away from the film coating with a pocked knife and licked it from the counter. It didn't seem like much, but it was enough to make my tongue numb. Anyway, I figured that I took about 2 mg, or something like that. Well, it quelched the anxiety nicely, and within about 45 minutes I had to go to bed. I barely got my pants off and the covers back before I passed out. I damn near wet the bed because I was too tired to get up and pee...I mean, I was OUT of it, really f*cked up. All day today I was fatigued and only managed to scrape by with caffeine and a 4 hour nap from 2:00 - 6:00 pm.
So my question is: is it really possible to be *that* sensitive to antihistaminic drugs? I entertained the idea that it was the placebo effect, but does the placebo effect work while you're sleeping? I mean, usually I wake up when I have to pee, but I just couldn't. I had hours and hours of dreams where I was trying to pee, but I couldn't wake up. If it was the placebo effect, it wouldn't be active in my sleep would it?
Anyway, what does it say about brain chemistry to be so sensitive to antihistamines? My parents learned the hard way when they gave me an antihistamine as a kid. I went into a complete rage: screaming, kicking, breaking things, etc. I remember it slightly...I was completely, insanely enraged, and felt like I wanted to rip the flesh off of my bones. I've felt milder cases of this sensation as a kid with restless leg syndrom, but never in my whole body like I did when they gave me Actifed (pseudoephedrine + triprolidine). I had had pseudoephedrine many times without side effects, so it must have been the triprolidine in it that made me freak out.
So anyway, my question is this...does hypersensitivity to antihistamines (e.g. insane, maddening akathisia-rage as a kid and hypersomnolence as an adult) give any insight into my "condition," as you might call it? Does it elucidate any aberrant brain chemistry or physiology? Because of it I can't take any systemic allergy medicine, no APs (haven't tried Geodon, though), no tricyclics, and no more than a insanely small doses of Remeron.
OK, I am a freak. What does it mean??
Posted by SalArmy4me on August 10, 2001, at 6:38:27
In reply to OK, am I just a freak? (long), posted by MB on August 10, 2001, at 0:52:59
You might have something known as Multiple Chemical Sensativities, but only a doctor could tell you if that was your true diagnosis.
You will eventually develop a tolerance to Remeron if you take it regularly, and of course, higher doses of Remeron means less side-effects according to clinical lore. But actually, there is no proof of increased clinical efficacy with Remeron in doses over 15mg (decreased side-effects, yes). This is something that few people know (http://www.preskorn.com/cgi-bin/sp.pl?words=mirtazapine&wt=be&bl=an&d=/columns/0003.html). So if you can just get to 15 mg, you might have a chance to make it out of depression with Remeron alone.
Or you could just switch to a more stimulating antidepressant like venlafaxine, buproprion, selegiline, or tranylcypromine.
Good luck.
Posted by MB on August 10, 2001, at 10:49:38
In reply to Re: OK, am I just a freak? (long) » MB, posted by SalArmy4me on August 10, 2001, at 6:38:27
> You might have something known as Multiple Chemical Sensativities, but only a doctor could tell you if that was your true diagnosis.
This sounds right because I'm also really sensitive to caffeine which I crave and can't give up. I've heard that a lot of times we crave the chemicals or foods we are allergic or sensitive to. That is a weird thing.
> Or you could just switch to a more stimulating antidepressant like venlafaxine, buproprion, selegiline, or tranylcypromine.
>
> Good luck.Venlafaxine and bupropion I've tried. They seem to do better than the SSRIs for my depression, but I can't cope with the stimulation. It's weird. I whine to the pdoc about being too fatigued, but when I take an energizing drug, I can't cope with the stimulation. I might be able to handle Effexor or Wellbutrin with a benzo, but now that I'm in alcohol recovery, I'm scared to take those drugs (also, no doc in his right mind wants to take the risk of prescribing a benzo to a recovering alcoholic). Maybe one of the stimulating ADs with a mood stabalizer might work. I dunno. I'm in between docs right now. I'm beating around the bush. These psychiatric drugs really scare me both because of negative experiences I've had in the past and because all the bad things I read about them on this board. Because of my last trial with bupropion, a childhood tic disorder has re-emerged, only much worse. I'm scared to death to try any APs, which I think a pdoc will want to try since the atypicals are the new trendy thing. Already, at this point, I can't quit shrugging my shoulders, blinking my eyes and grimacing with my mouth. I can't imagine how bad tardive dyskinesia would be, but I don't want to find out. Going crazy but scared to get help...know what I'm saying?
Posted by Mitch on August 10, 2001, at 12:06:20
In reply to OK, am I just a freak? (long), posted by MB on August 10, 2001, at 0:52:59
MB,
No you are not a freak. Remeron is just like that. I have done the exact thing you have done (I have a few tabs stashed) for bad sleep disturbances. I think they could market a very low dose of Remeron as a sleeper, say 2.5mg tabs.
Mitch
Posted by MB on August 10, 2001, at 16:40:25
In reply to Re: OK, am I just a freak? (long) » MB, posted by Mitch on August 10, 2001, at 12:06:20
> MB,
>
> No you are not a freak. Remeron is just like that. I have done the exact thing you have done (I have a few tabs stashed) for bad sleep disturbances. I think they could market a very low dose of Remeron as a sleeper, say 2.5mg tabs.
>
> Mitch
Maybe it's more sedating at those lower doses because you're not getting the noradrenergic stimulation? I've been told that if you up the dose with Remeron to 45mg, it's less sedating. I've always been WAY to nervous to try it. I get scared it won't work and I'll become Rip Van Winkle < g >.
Posted by Mitch on August 10, 2001, at 23:22:58
In reply to Re: OK, am I just a freak? (long) » Mitch, posted by MB on August 10, 2001, at 16:40:25
> Maybe it's more sedating at those lower doses because you're not getting the noradrenergic stimulation? I've been told that if you up the dose with Remeron to 45mg, it's less sedating. I've always been WAY to nervous to try it. I get scared it won't work and I'll become Rip Van Winkle < g >.MB,
Yes they are correct about higher doses being *somewhat* less sedating. I started out with 7.5mg at bedtime and then increased it to 15mg and then 30mg. It was like "still taking 100mg of Benadryl at nite minus the cottonmouth" but with a boosted norepinephrine effect the next day to *overcome* the sedation. Basically, the way I felt with it was that 7.5mg caused the SAME sedation as 30mg did, you just had more stimulant effect to *offset* the drowsiness. The "next-day fog" though seemed to blurr my cognition so badly (no matter what dose I took)that I had problems with work. I have a very high-tech detaily job and anything that disrupts my thinking just WRECKS my ability to do my job. The *NE boost* just wasn't quite enough, sorry Charlie. Hey, if they could find a way to hit the 5-HT and NE receptors without the antihistamine thing I would probably find it an AD of choice. It was one of only a few AD's that I can take a standard dose of-so that in itself is a pretty good deal.
Mitch
Posted by stjames on August 11, 2001, at 0:17:11
In reply to OK, am I just a freak? (long), posted by MB on August 10, 2001, at 0:52:59
(I don't think it warrants the lable "panic attack," but it *did* comprise moderate chest pain, sweating, slow but earth-shattering heart beat, feelings of immanent evil--like the way things look in a nightmare, etc)
James here....
Are you joking ? You just described a real panic attack to a tee.
james
Posted by Mr. Scott on August 12, 2001, at 23:41:58
In reply to OK, am I just a freak? (long), posted by MB on August 10, 2001, at 0:52:59
I respond the same way to that Remeron crap. I took 3.75 mg and slept for a whole day and ate like a pig. Anxious people are very sensitive to all kinds of drugs. Remeron is definately off my list of noteworthy substances.
Posted by karenR on August 13, 2001, at 13:20:45
In reply to OK, am I just a freak? (long), posted by MB on August 10, 2001, at 0:52:59
Hi MB,
I was wondering about this "panic attack" that you had. Have you had this
sensation before? From what you wrote, it sounds like it could have been
a night terror. I've been suffering from these for my entire life. Only in
the last 7years did I find out they weren't nightmares. You wake up, heart
beating SO HARD, but not fast, you think you are going to die because your
heart beats so hard. You are afriad of something, but can't place it. It's
hard to wake up from it too. Ironically, I don't remember these episodes'
too often, unless I am alone. Anyway, it's worth looking into.I took remeron for anxiety and found it very sedating too. I actually found that
it made my night terrors worse, even though I was so tired. For sleep, I found
zoloft to help me greatly, but I needed more of an anti-anxiety med.Anyway, when you had the panic attack, did it feel better after about 10 mins,
or were you feeling upset for a long time (an hour or more) after? I really don't
know how to discern a night terror from a panic attack. In the last year I developed
"breathing" problems that would wake me from my sleep in a panic. I think
they were different from the night terrors where my heart would just race and
I'd be terrified.Good luck,
Karen
Posted by DP on August 13, 2001, at 20:03:27
In reply to Re: OK, am I just a freak? (long) » MB, posted by SalArmy4me on August 10, 2001, at 6:38:27
> You might have something known as Multiple Chemical Sensativities, but only a doctor could tell you if that was your true diagnosis.
>
> You will eventually develop a tolerance to Remeron if you take it regularly, and of course, higher doses of Remeron means less side-effects according to clinical lore. But actually, there is no proof of increased clinical efficacy with Remeron in doses over 15mg (decreased side-effects, yes). This is something that few people know (http://www.preskorn.com/cgi-bin/sp.pl?words=mirtazapine&wt=be&bl=an&d=/columns/0003.html). So if you can just get to 15 mg, you might have a chance to make it out of depression with Remeron alone.
>
> Or you could just switch to a more stimulating antidepressant like venlafaxine, buproprion, selegiline, or tranylcypromine.
>
> Good luck.Venlafaxine. . . Effexor?!?! A stimulating AD? I'm curious how that's so. . . (because I'm taking it and don't feel ANY stimulating effects).
Thanks,
Jimmy
Posted by DP on August 13, 2001, at 20:12:40
In reply to Re: OK, am I just a freak? (long) » MB, posted by karenR on August 13, 2001, at 13:20:45
OMG it's so comforting to know there are *ACTUALLY* people out there that are going through the same thing I am.
I recently have been getting quite a few panic attacks due to an eating disorder (imagine that) that scared the living s**t out of me.
My doctor presecribed me something called Lorazepam (0.5mg used-as-needed type thing) when I feel an attack coming on. He also told me to use it when I have trouble falling asleep.
It's worked quite nicely for BOTH indications.
Anyone care to comment?
Posted by jodee on August 14, 2001, at 22:09:58
In reply to Re: OK, am I just a freak? (long), posted by DP on August 13, 2001, at 20:12:40
> I had the same result on remeron-knocked me out cold practically! I thought it was just me so I'm glad you brought this up. I have a hard time finding the right balance between the activating antidepressants and the deactivating... I tend to sleep alot anyway when I'm depressed so it sucks when a med just increases my inability to get out of bed! Now I am on a mix of prozac and neurontin. Finding the right mix is like searching for the Holy Grail! peace, Jodee
Posted by MB on August 20, 2001, at 15:02:20
In reply to Re: OK, am I just a freak? (long), posted by stjames on August 11, 2001, at 0:17:11
> (I don't think it warrants the lable "panic attack," but it *did* comprise moderate chest pain, sweating, slow but earth-shattering heart beat, feelings of immanent evil--like the way things look in a nightmare, etc)
>
> James here....
>
> Are you joking ? You just described a real panic attack to a tee.
>
> jamesA friend of mine has panic attacks. When she has one, she really freaks, has to run outside and she hyperventilates. If what I'm having *are* panic attacks, they must be mild compared to hers. I can sit there wanting to die, but I've only had to run out of the room a couple times (thank god).
Posted by MB on August 20, 2001, at 15:10:34
In reply to Re: OK, am I just a freak? (long) » MB, posted by karenR on August 13, 2001, at 13:20:45
> Hi MB,
>
> I was wondering about this "panic attack" that you had. Have you had this
> sensation before? From what you wrote, it sounds like it could have been
> a night terror.Well, I did have an experience that was like a panic attack that woke me up out of my sleep. The fear was unreal, like as if I had awakened to a murderer standing above me with an axe.
All the other experiences happen throughout the day. They last hours.
I've been suffering from these for my entire life. Only in
> the last 7years did I find out they weren't nightmares. You wake up, heart
> beating SO HARD, but not fast, you think you are going to die because your
> heart beats so hard. You are afriad of something, but can't place it.
This is exactly like my nightime experience. I bet it's what happens when a person has a panic attack in there sleep.
> hard to wake up from it too. Ironically, I don't remember these episodes'
> too often, unless I am alone. Anyway, it's worth looking into.My experience wasn't hard to wake up from. I sat right up in my bed with enough adrenaline going through my veins to kill an elephant, yet I had no idea what I was afraid of...but there was a sense that something was in the room with me (a vestige of a nightmare, maybe?). My heart was beating about 50 bpm, but so hard that my body shook and I could hear the blood in coarse through my ears. It made my chest hurt. Pretty freaky.
Posted by MB on August 20, 2001, at 15:26:29
In reply to Re: OK, am I just a freak? (long), posted by stjames on August 11, 2001, at 0:17:11
I assume that caffeine makes panic attacks a whole lot worse. I've been drinking about two cups a day (maybe one around 8:00am and another around 1:00pm). The caffeine seems to relax me and center me, but about two or three hours after I drink it, the panic/racing-thoughts/chest-pain/sweating symptoms come on strong. Plus, this feeling of horrible guilt (that I didn't describe before) hits me. The guilt is incapacitating; like I've murdered someone, but I can't think of anything bad that I've done. I feel so guilty that I'm sure I'm going to hell, and the sensation is that there is an evil presence, immanent, waiting to take me there. The religious overtones of the sensation worries me because in retrospect it seems reminiscent of psychosis (but there are no delusions of a commited act, just the *feeling* of guilt and evil). Could the coffee be causing the attacks so long after I drink it? I like to drink it (for depression), but this panic/anxiety feels worse than depression. Without it I get so depressed that I can't be productive. For the next week, I'm free of responsibilities (well, relatively), so I don't need to be productive. I'm going to try to give up the caffeine and see how things go. Today is the first day off the java: fatigued and ravenous, but no headache yet. I hope this helps.
Posted by Mr.Scott on August 20, 2001, at 17:10:26
In reply to Caffeine's role in these issues, posted by MB on August 20, 2001, at 15:26:29
the influence of caffeine is grossly underestimated by many.
Posted by MB on August 21, 2001, at 0:25:07
In reply to Re: Caffeine's role in these issues, posted by Mr.Scott on August 20, 2001, at 17:10:26
> the influence of caffeine is grossly underestimated by many.
My addiction was underestimated by me. I slept all day hoping to get some energy, but no matter how much I slept, I couldn't function. The lawn hadn't been mowed for 2 weeks...it had to be done. I broke down and drank a cup of black tea around 4:00pm so I could get out of bed and do it.
Posted by Mr.Scott on August 21, 2001, at 9:07:46
In reply to Re: Caffeine's role in these issues, posted by MB on August 21, 2001, at 0:25:07
Maybe Tea or Coke can help you wean yourself away from the big black beast.
Posted by karenR on August 21, 2001, at 10:18:22
In reply to Re: OK, am I just a freak? (long) » karenR, posted by MB on August 20, 2001, at 15:10:34
Hi MB,
Here's a site to look at if you are interested:
This describes night terrors very well. It's also
a good place to ask questions about it. I haven't found a
"solution" to the problem, except, believe it or not,
a 32 year old women (me!) uses a nightlight EVERYWHERE I go.
That's what works for me, but, certainly not for everyone.
I honestly don't know much about panic attacks vs night terrors.
I don't believe anyone has been able to adequately define the
difference.Good luck!
Karen>
> My experience wasn't hard to wake up from. I sat right up in my bed with enough adrenaline going through my veins to kill an elephant, yet I had no idea what I was afraid of...but there was a sense that something was in the room with me (a vestige of a nightmare, maybe?). My heart was beating about 50 bpm, but so hard that my body shook and I could hear the blood in coarse through my ears. It made my chest hurt. Pretty freaky.
Posted by MB on August 21, 2001, at 15:58:11
In reply to Re: Caffeine's role in these issues, posted by Mr.Scott on August 21, 2001, at 9:07:46
> Maybe Tea or Coke can help you wean yourself away from the big black beast.
Yeah, I think I'll try that. The tea seems to cover the withdrawal without making me have panic attacks later in the day.
You know, it's a strange thing, but when I'm stressed, my reaction is to grab caffeine. This is the weirdest type of self-medication, I think, because the caffeine obviously doesn't help with the anxiety. I hope I can eventually get off of it.
Also, they sell these little mints at the grocery store where I live called Penguins. They are caffeinated mints. They are pretty mild (nowhere near no-doz or anything like that). Maybe when the headaches get bad, I could eat one of those...probably even less caffeine than a cup of tea.
Posted by MB on August 21, 2001, at 16:10:49
In reply to Re: OK, am I just a freak? (long) » MB, posted by karenR on August 21, 2001, at 10:18:22
> Hi MB,
>
> Here's a site to look at if you are interested:
> http://www.nightterrors.org/I am interested! Thanks for the link. I also leave lights on in the house when I'm sleeping. What I found interesting at the sight was a description of a phenomenon that I get frequently, but which doesn't seem to have the "adrenaline rush" component that my "sudden awakenings" do. That phenomenon is the weird combo of sleep and wakefulness where you can look around the room, but the body is paralyzed. I hate that. Often (I think as a remenant of a dream) I can see a person in the room with me...someone trying to get me, etc, but I can't move...I'm paralyzed. When the ability to move comes back, the vision dissapates. It's like having a nightmare with your eyes open. I *HATE* that.
>
> This describes night terrors very well. It's also
> a good place to ask questions about it. I haven't found a
> "solution" to the problem, except, believe it or not,
> a 32 year old women (me!) uses a nightlight EVERYWHERE I go.
> That's what works for me, but, certainly not for everyone.
> I honestly don't know much about panic attacks vs night terrors.
> I don't believe anyone has been able to adequately define the
> difference.
>
> Good luck!
> Karen
Posted by DP on August 21, 2001, at 16:17:16
In reply to Re: Caffeine's role in these issues » Mr.Scott, posted by MB on August 21, 2001, at 15:59:08
Ok, can I just make a comment about that last post? I have been diagnosed as being panick attack-prone and the doctor attributed it partly to my caffeine addiction. I completely understand the catch-22 situation - you need it because you're addicted to it, yet it causes panic attacks.
While I've been successful getting rid of the coffee in my life, I still have caffeine cravings. Those Penguin mints are AWESOME, because like MB said, the caffeine's not nearly strong enough, but it's there to slowly wean you off.
Posted by susan C on August 21, 2001, at 17:00:34
In reply to Re: Caffeine's role in these issues, posted by DP on August 21, 2001, at 16:17:16
> Ok, can I just make a comment about that last post? I have been diagnosed as being panick attack-prone and the doctor attributed it partly to my caffeine addiction. I completely understand the catch-22 situation - you need it because you're addicted to it, yet it causes panic attacks.
>
> While I've been successful getting rid of the coffee in my life, I still have caffeine cravings. Those Penguin mints are AWESOME, because like MB said, the caffeine's not nearly strong enough, but it's there to slowly wean you off.Just a note from a non caffine person...
One day someone put real stuff in the decaf jug at work and I about bounced off the walls...Later I realized I couldn't even drink decaf. It also makes my heart race. What is the abbreviation? Milage varies? I love the smell, tho.susan C
Posted by Zo on August 21, 2001, at 21:25:28
In reply to Caffeine's role in these issues, posted by MB on August 20, 2001, at 15:26:29
Woops. . if caffiene centers and calms/organizes one, that's highly indicative of ADD, or, more properly called: a dopamine deficiency.
Zo
This is the end of the thread.
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