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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by James on April 17, 2002, at 21:35:27
Occasionally, when I'm in btw manic and depressed states, I take Tylenol PM or Excedrin PM to help get to sleep. When I'm manic I don't feel it and when I'm down I don't need it, so really the question is for the rare time I'm in btw. Or even better, to augment another med which is also being used to put me to sleep. Now I'm pretty sure that Diphenhydramine Citrate, the active
"sleep" ingredient in Excedrin PM and Tylenol, is the same thing as the one in benadryl. Even if I'm wrong, does anybody know if there is any danger of an interaction btw the Excedrin PM and the Risperdal, Gabitril, Lamictal, or Adderall I'm taking. I know its a long list, but I'll use whatever I can get to help me get to sleep. Esp because that lack of sleep often sends me into a cycle which leads swiftly to mania. And also, I'm freakin tired during the day when I can't sleep at night. For example, I never used to fall asleep in classes, because I thought it was gross disrespect to the prof, its like giving him the bird and saying I don't care about you or what you have to say. So I never permitted myself to do that. But in terms of getting bored, which is a real problem for me--necause of my ADD-- now even Dylan Thomas sounds like War and Peace!
James
Posted by JohnX2 on April 18, 2002, at 0:02:30
In reply to Possible interaction with Risperdal and/or Gabitri, posted by James on April 17, 2002, at 21:35:27
> Occasionally, when I'm in btw manic and depressed states, I take Tylenol PM or Excedrin PM to help get to sleep. When I'm manic I don't feel it and when I'm down I don't need it, so really the question is for the rare time I'm in btw. Or even better, to augment another med which is also being used to put me to sleep. Now I'm pretty sure that Diphenhydramine Citrate, the active
> "sleep" ingredient in Excedrin PM and Tylenol, is the same thing as the one in benadryl. Even if I'm wrong, does anybody know if there is any danger of an interaction btw the Excedrin PM and the Risperdal, Gabitril, Lamictal, or Adderall I'm taking. I know its a long list, but I'll use whatever I can get to help me get to sleep. Esp because that lack of sleep often sends me into a cycle which leads swiftly to mania. And also, I'm freakin tired during the day when I can't sleep at night. For example, I never used to fall asleep in classes, because I thought it was gross disrespect to the prof, its like giving him the bird and saying I don't care about you or what you have to say. So I never permitted myself to do that. But in terms of getting bored, which is a real problem for me--necause of my ADD-- now even Dylan Thomas sounds like War and Peace!
>
>
> JamesBenadryl is Diphenhydramine.
Tylenol PM and Excedrine PM have Acetaminophen and Diphenhydramine. The Diphenhydramine is the sleep aid. So you can just take Benadryl for sleep. (Acetaminophen can be a bit tough on the liver over time). But check your doc for drug interactions.hmm...Maybe you could swap out the Risperdal for the AP Seroquel? The Seroquel has antihistamine properties...better for sleep.
I don't know off hand about drug interactions though. Anyone..Anyone..John
Posted by JohnX2 on April 19, 2002, at 1:15:52
In reply to Re: Possible interaction with Risperdal and/or Gabitri » James, posted by JohnX2 on April 18, 2002, at 0:02:30
> > Occasionally, when I'm in btw manic and depressed states, I take Tylenol PM or Excedrin PM to help get to sleep. When I'm manic I don't feel it and when I'm down I don't need it, so really the question is for the rare time I'm in btw. Or even better, to augment another med which is also being used to put me to sleep. Now I'm pretty sure that Diphenhydramine Citrate, the active
> > "sleep" ingredient in Excedrin PM and Tylenol, is the same thing as the one in benadryl. Even if I'm wrong, does anybody know if there is any danger of an interaction btw the Excedrin PM and the Risperdal, Gabitril, Lamictal, or Adderall I'm taking. I know its a long list, but I'll use whatever I can get to help me get to sleep. Esp because that lack of sleep often sends me into a cycle which leads swiftly to mania. And also, I'm freakin tired during the day when I can't sleep at night. For example, I never used to fall asleep in classes, because I thought it was gross disrespect to the prof, its like giving him the bird and saying I don't care about you or what you have to say. So I never permitted myself to do that. But in terms of getting bored, which is a real problem for me--necause of my ADD-- now even Dylan Thomas sounds like War and Peace!
> >
> >
> > James
>
> Benadryl is Diphenhydramine.
> Tylenol PM and Excedrine PM have Acetaminophen and Diphenhydramine. The Diphenhydramine is the sleep aid. So you can just take Benadryl for sleep. (Acetaminophen can be a bit tough on the liver over time). But check your doc for drug interactions.
>
> hmm...Maybe you could swap out the Risperdal for the AP Seroquel? The Seroquel has antihistamine properties...better for sleep.
> I don't know off hand about drug interactions though. Anyone..Anyone..
>
> JohnJames,
How often do you cycle? Manic/depressed?
Did you find the Lamictal induced manic behavior?
Or possibly the Adderall?FYI, the zyprexa you were taking is approved to treat bipolar disorder:
http://www.bipolardisorder.com/bip/html/zybipolar.shtml
Most of these antipsychotics can be useful to treat bipolar disorder (don't let the name "antipsychotic" scare you).
Has your doctor tried other mood stabilizers (Depakote, Tegretol, Trileptal, Lithium ?)
John
Posted by James on April 19, 2002, at 13:00:06
In reply to Re: Possible interaction with Risperdal and/or Gabitri, posted by JohnX2 on April 19, 2002, at 1:15:52
I am presently on Lamictal (200 mgs, once a day) which has been, and hopefuly will continue, working somewhat well as a mood stabilizer.
How often do I cycle? Well, the truth is I'm not really certain. My diagnosis is quite recent--middle of last year-- and I am only 21 so I don't have that much previous history to to review for possible patterns.
Unfortunately, I'm incapable of seperating the effects of the Lamictal from the other drugs I'm on, which currently is Gabitril. However, Lam was working fine until a few weeks ago. Then the fun began. I have been on Adderall for about 4 or five years, and before that was on Ritalin for one year, all for ADD. I don't remember why I stopped the Ritalin but after I switched to the Adderall things were great ADD-wise. What I didn't notice then, but now see in retrospect, is that I was steadily increasing the dosage of Adderall and times per day. So, beginning of the year I ran into severe ADD difficulties which couldn't have come at a worse time in my academic career: junior year in college. So I kept on having more and more difficulties until two months ago when I discovered that Adderall wasn't adding anything for my ADD. Since I was in Finals then, I got really frantic and persuaded my pdoc to give me a heck of a lot of Adderall to do school and we'd untangle the mess after finals. So I began taking a heck of a lot of Adderall, more even than my regular 30 mgs 4 times a day. And it was just going right through me, not doing a thing. At one point I was taking 30 mgs about 6 times a day. So after finals, which btw, I did miserably on, I stopped the Adderall cold turkey in an attempt to have a little vacation and fix the poop out. I was able to stop cold turkey because I had done it a plenty of times before, when the evil insurance companie shad arbitrarily decided not to cover Adderall once I was 18 because, get this, ADD is only a childhood thing. Needless to say, I threw a violent fit and after a couple of death threats and after a few calls from my dad, an oncologist hematologist who has an insane driven hate for al l insurance, I was able to get Adderall after a few days. But they did the same thing to me about ten times, each time requiring the same Hurculean efforts. So I stopped cold turkey and had some withdrawel symptoms. Ok no big deal, I'd been there before. But since now I was aware that I was bipolar and the withdraw from the Adderall would likely cause a bad dysthymia/depression the pdoc gave me some Wellbutrin to pick me up a little bit. We chose Wellbutrin because I remembered that when I was 15 I had taken it with good results. Well, it was either Wellbutrin or Dexadrine I told the pdoc. Guess it was Dexadrine because I was in a pretty bad state over that vacation and I was so out of it, I didn't know I was out of it. Quite frightening. So, that sent me manic, and then she gave the Gabitril and Risperdal. Thats the story.
Oh yeah, I stopped the Risperdall yesterday because of side effects that put the fear of G-D into me--possible Tardive Dyskenesia type things. Which, needless to say, was hardly comforting. So thats that.
I was on Depakote beofre but the Lamictal worked better so I switched.
I'm surprised I had the concentration to write for this long. And thank you very much for asking about my wellfare. Nobody else knows about what I'm dealing with other than you guys, and I really appreciate the support.
James.
Posted by JohnX2 on April 19, 2002, at 15:29:49
In reply to Re: Possible interaction with Risperdal and/or Gabitri, posted by James on April 19, 2002, at 13:00:06
> I am presently on Lamictal (200 mgs, once a day) which has been, and hopefuly will continue, working somewhat well as a mood stabilizer.
> How often do I cycle? Well, the truth is I'm not really certain. My diagnosis is quite recent--middle of last year-- and I am only 21 so I don't have that much previous history to to review for possible patterns.
> Unfortunately, I'm incapable of seperating the effects of the Lamictal from the other drugs I'm on, which currently is Gabitril. However, Lam was working fine until a few weeks ago. Then the fun began. I have been on Adderall for about 4 or five years, and before that was on Ritalin for one year, all for ADD. I don't remember why I stopped the Ritalin but after I switched to the Adderall things were great ADD-wise. What I didn't notice then, but now see in retrospect, is that I was steadily increasing the dosage of Adderall and times per day. So, beginning of the year I ran into severe ADD difficulties which couldn't have come at a worse time in my academic career: junior year in college. So I kept on having more and more difficulties until two months ago when I discovered that Adderall wasn't adding anything for my ADD. Since I was in Finals then, I got really frantic and persuaded my pdoc to give me a heck of a lot of Adderall to do school and we'd untangle the mess after finals. So I began taking a heck of a lot of Adderall, more even than my regular 30 mgs 4 times a day. And it was just going right through me, not doing a thing. At one point I was taking 30 mgs about 6 times a day. So after finals, which btw, I did miserably on, I stopped the Adderall cold turkey in an attempt to have a little vacation and fix the poop out. I was able to stop cold turkey because I had done it a plenty of times before, when the evil insurance companie shad arbitrarily decided not to cover Adderall once I was 18 because, get this, ADD is only a childhood thing. Needless to say, I threw a violent fit and after a couple of death threats and after a few calls from my dad, an oncologist hematologist who has an insane driven hate for al l insurance, I was able to get Adderall after a few days. But they did the same thing to me about ten times, each time requiring the same Hurculean efforts. So I stopped cold turkey and had some withdrawel symptoms. Ok no big deal, I'd been there before. But since now I was aware that I was bipolar and the withdraw from the Adderall would likely cause a bad dysthymia/depression the pdoc gave me some Wellbutrin to pick me up a little bit. We chose Wellbutrin because I remembered that when I was 15 I had taken it with good results. Well, it was either Wellbutrin or Dexadrine I told the pdoc. Guess it was Dexadrine because I was in a pretty bad state over that vacation and I was so out of it, I didn't know I was out of it. Quite frightening. So, that sent me manic, and then she gave the Gabitril and Risperdal. Thats the story.
> Oh yeah, I stopped the Risperdall yesterday because of side effects that put the fear of G-D into me--possible Tardive Dyskenesia type things. Which, needless to say, was hardly comforting. So thats that.
> I was on Depakote beofre but the Lamictal worked better so I switched.
> I'm surprised I had the concentration to write for this long. And thank you very much for asking about my wellfare. Nobody else knows about what I'm dealing with other than you guys, and I really appreciate the support.
>
>
> James.Believe it or not some doctors think that adult ADD is manifested by addiction (to psychostimulants). Some doctors actually do buy into the hypothesis that ADD is a childhood thing.
Sorry to hear such a horror story. I had my own Adderall disaster (but the medicine works great for many people).
APs (antipsychotics) from what I can see at the lower doses have a low propensity to case Tardive Dykinesia. At the very strong doses (to curb bad mania), I have seen sparse reports of potential AP induced tardive dykinesia/dystonia. One has to trade off the risks of the medicine and the benifits it provides. They are life savers for many people.
Maybe the Wellbutrin trial isn't such a bad idea long term.
Take Care,
John
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