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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Festus on August 28, 2003, at 21:54:58
I see a Pain Doc and a Mind Doc.Between them,I,m taking a schedule of these meds:
Methadone-10mgx8-10
Dexedrine-10mgx6
Paxil CR-25mg
Xanax -.05x3
Restoril-15mgx1
Does anyone have any specifics on the use of these,longterm?I,m a little scared about it.BTW,both docs know what I,m taking.Festus
Posted by nutcase on August 29, 2003, at 12:55:25
In reply to SCARED !!! Need advice on safety of drug regimen., posted by Festus on August 28, 2003, at 21:54:58
If both of your docs know about all of the drugs you are taking, you should be OK. It is also helpful if you get all of your Rx filled at the same pharmacy. They can also spot if something is wrong or put your mind at ease. Finally, know what side effects to watch for and listen to your body. Then RELAX.
If you want to do some research of your own, go to one of the big chain bookstores, e.g., Barnes and Noble or Borders. You can browse through the latest version of the PDR or Merck Manual for Nurses. The website www.medscape.com has a lot of information. In addition, you can sign up for weekly newsletters targeted to psychiatry (and any other part of the body too). Its all free.
> I see a Pain Doc and a Mind Doc.Between them,I,m taking a schedule of these meds:
> Methadone-10mgx8-10
> Dexedrine-10mgx6
> Paxil CR-25mg
> Xanax -.05x3
> Restoril-15mgx1
> Does anyone have any specifics on the use of these,longterm?I,m a little scared about it.BTW,both docs know what I,m taking.Festus
Posted by Ima on August 29, 2003, at 17:21:01
In reply to Re: SCARED !!! Need advice on safety of drug regimen., posted by nutcase on August 29, 2003, at 12:55:25
arent xanax and paxil both ssri's ?
If so why take both?
Ima
Posted by Ame Sans Vie on August 30, 2003, at 16:44:59
In reply to Re: SCARED !!! Need advice on safety of drug regimen., posted by Ima on August 29, 2003, at 17:21:01
Xanax is a benzodiazepine; Paxil is a selective serotonin reuptake inhibitor.
Restoril is also a benzodiazepine, temazepam, but it's used for sleep, not anxiety/panic relief like Xanax is. And even taking two benzos for anxiety relief is not entirely uncommon -- I take both Klonopin Wafers and Xanax XR. They have somewhat different effects and used together they provide me with much greater relief than I could ever have from either one used on its own.
Posted by Ima on August 30, 2003, at 17:06:18
In reply to Re: SCARED !!! Need advice on safety of drug regimen. » Ima, posted by Ame Sans Vie on August 30, 2003, at 16:44:59
ASV
Im still trying to figure this out.
Im probably BP with mixed states and of course a single medication regimen is unlikely for me.But Im really freaked out when I read about people taking so many meds at one time just to feel normal.
Could you please answer some questions for me?
How long did it take for you to settle on this combination of meds?
How many times have you had to change regimens before you were sucessful?
How long have you been on this one?
Thanx
peace
Ima
Posted by Ame Sans Vie on August 30, 2003, at 23:33:24
In reply to Re: SCARED !!! Need advice on safety of drug regimen. » Ame Sans Vie, posted by Ima on August 30, 2003, at 17:06:18
> Could you please answer some questions for me?
Sure.
> How long did it take for you to settle on this combination of meds?Over seven years.
> How many times have you had to change regimens before you were sucessful?
Oh my gods... 150? 200? More? I honestly have no idea, but it's way, way up there.
> How long have you been on this one?
One month now with the Klonopin, Xanax, Dexedrine, and Ultram all together, though before that I was on the benzos and Ultram for another month. Klonopin has played a pretty consistent role in my treatment and I've been taking it for over three years now, with only a few brief hiatuses (hmm... hiati?).
Posted by Viridis on August 31, 2003, at 1:56:17
In reply to Re: SCARED !!! Need advice on safety of drug regimen. » Ame Sans Vie, posted by Ima on August 30, 2003, at 17:06:18
I wouldn't worry about taking multiple meds, if you have a good pdoc. I do much better with a small amount of several meds than a lot of any one. It's just a matter of getting the mix right, which really takes an expert and some trial and error.
I think that one of the most unfortunate strategies is the "magic med" approach -- the idea that one medication will fix everything. That may work for some people, but many just suffer needlessly from side effects etc, without getting proper relief. I know -- I tried that for quite a few years before I found the right pdoc.
Posted by Ima on August 31, 2003, at 9:22:26
In reply to Re: SCARED !!! Need advice on safety of drug regimen. » Ima, posted by Ame Sans Vie on August 30, 2003, at 23:33:24
>
> > How many times have you had to change regimens before you were sucessful?
>
> Oh my gods... 150? 200? More? I honestly have no idea, but it's way, way up there.Im really concerned about having to go through a process that may require multiple withdraw scenarios.
How difficult was it for you to change so often from one med to another. Was it disruptive to your ability to function?
I have young children at home and I home school. Going through so much trial and error could be quite difficult for me, (more specifically for my children)
>
> > How long have you been on this one?
>
> One month now with the Klonopin, Xanax, Dexedrine, and Ultram all together, though before that I was on the benzos and Ultram for another month. Klonopin has played a pretty consistent role in my treatment and I've been taking it for over three years now, with only a few brief hiatuses (hmm... hiati?).Can I ask you why you are taking ultram? I have been prescribed it as a pain reliever. I have seen info that it effects serotonin levels, and therefore has the effect of an anti-depressant. Was it prescribed for your mood disorder or for pain? At the moment, I think it is adversely affecting my BP, increasing mania..etc. I am not on a mood stabilizer. I think no one has figured out Im BP yet.
By lurking about I feel almost certain that Im BP2 and will reguire a multiple med regimen.
I have been through 2 pdocs with no accurate diagnosis.(Both recomended ADS). I ended up with serotonin syndrome. So Im trying a third(doc) this week.
Many here have found good docs and sucessful treatment because of it. Good docs dont seem to be part of my karma. I feel I need to be prepared with ideas, to help eliminate so much guess work and spare my family (and myself) a plethora of trials.
I realize that its unlikely meds wont have to be tweaked or changed. I just want to do as much legwork as possible. Ive learned alot here already.
Thanx
peace
Ima
Posted by Ame Sans Vie on August 31, 2003, at 11:19:55
In reply to Re: SCARED !!! Need advice on safety of drug regimen., posted by Ima on August 31, 2003, at 9:22:26
> Im really concerned about having to go through a process that may require multiple withdraw scenarios.
Well, many of the medications don't cause any appreciable symptoms upon withdrawal. Amongst the most commonly prescribed psychotropic medications, it's mainly the SSRIs (with the possible exception of Prozac) and Effexor that are notorious for their hellish withdrawal. (Yeah, yeah, I know -- benzos and stimulants too, but unlike those antidepressants, one can be withdrawn from these rather painlessly, provided the doctor knows what he/she is doing... and I'd take benzo withdrawal over SSRI withdrawal any day!)
> How difficult was it for you to change so often from one med to another. Was it disruptive to your ability to function?
I wasn't able to function at all as it was, so all the med-switching didn't really disrupt my non-existent ability to function :-). But had I been someone who was able to carry out a fairly normal life without medication, I'm sure that the side effects, especially, would have interfered severely.
> I have young children at home and I home school. Going through so much trial and error could be quite difficult for me, (more specifically for my children)
All the more reason to find the best doctor you can, bring in research on medications that may be helpful, and just push and push and push until you get what you need to recover.
> Can I ask you why you are taking ultram? I have been prescribed it as a pain reliever. I have seen info that it effects serotonin levels, and therefore has the effect of an anti-depressant. Was it prescribed for your mood disorder or for pain? At the moment, I think it is adversely affecting my BP, increasing mania..etc. I am not on a mood stabilizer. I think no one has figured out Im BP yet.
I take the Ultram for depression and obsessive-compulsive personality disorder. It actually inhibits reuptake of both serotonin and norepinephrine, in addition to being a mu-opioid agonist, albeit a mild one (a potency about 1/6,000 of that of morphine; its active metabolite is more active at the mu-opioid receptors though). I do have fibromyalgia though, and the Ultram helps a bit, especially because I'm allergic to all OTC pain meds.
I could certainly see how Ultram could trigger mania... why don't you tell your physician this and try a different narcotic? Tylenol #1-4 or codeine sulfate tablets (w/o acetaminophen) are very good and about as effective as Ultram; Vicodin, Vicoprofen, Norco, Anexsia, Lortab, Percocet, Percodan etc. are also quite similar in their pain-relieving effects. Though others may disagree with me on this, this is my personal experience. I can't take Vicodin, Vicoprofen, Lortab, Percodan etc. because of the APAP and NSAIDs they contain, but I have tried oxycodone and hydrocodone alone; I honestly don't feel they're any stronger than the Ultram for relieving pain. People looking for a high though are usually fairly disappointed with Ultram, except at very high doses (400mg+), so they'll tend to say that it's a pretty crappy drug.
> By lurking about I feel almost certain that Im BP2 and will reguire a multiple med regimen.
Well, if BP II ends up being the case, at least two meds is most likely... one for mood-stabilization and one for depression (though you may be lucky enough to do just fine on a mood-stabilizer alone). A pretty popular combination these days is Lamictal (for depression) and lithium (as an anti-manic).
> I have been through 2 pdocs with no accurate diagnosis.(Both recomended ADS). I ended up with serotonin syndrome. So Im trying a third(doc) this week.
Good luck! :-)
> Many here have found good docs and sucessful treatment because of it. Good docs dont seem to be part of my karma. I feel I need to be prepared with ideas, to help eliminate so much guess work and spare my family (and myself) a plethora of trials.
Oh, believe me, I totally understand. I went through all 13 psychiatrists in my area, and now finally found one who is just incredible -- he'll listen to anything you have to say, he's never judgmental, and he's always open to new ideas. Unfortunately, his office is 50 miles away, lol.
Posted by Ima on August 31, 2003, at 12:36:12
In reply to Re: SCARED !!! Need advice on safety of drug regimen. » Ima, posted by Ame Sans Vie on August 31, 2003, at 11:19:55
... and I'd take benzo withdrawal over SSRI withdrawal any day!
I heartily agree. Ive been on and off percocet for a year. Some well meaning friends thought I would end up in betty ford clinic if I didnt "dry out". I just dropped it like a hot potatoe! No withdrawals, not unusual ones for me, in any case.
Im also fibro and have chronic back pain. The Percocet was great for my pain and my mood, but in retro I think it was starting to trigger mania. Most pain meds do that to me. I dont get the typical dreamy experience. I think how much pain your in affects your tolerance and Ive been in som much pain I couldnt move for a month.Anyway,I ve heard some say the ultram is harder to kick than morphine. I missed a day a few days ago and had this horrible crying jag. Geez, I dont know where that came from. I feel like cr*p at the moment.
Im tapering from a whopping 50mg to half a pill a day this week to see if I can get off it before my visit with the new pdoc, start with as clean a slate as possible.
> I wasn't able to function at all as it was, so all the med-switching didn't really disrupt my non-existent ability to function :-). But had I been someone who was able to carry out a fairly normal life without medication, I'm sure that the side effects, especially, would have interfered severely.Hey we have functioning dysfuntion in common! Even though I have a functioning facade my kids already think my insanity is just Mom! I just hope they dont catch on before their grown.
Just curious..if you were a functioning depressed person, what motivated you to seek treatment?
> All the more reason to find the best doctor you can, bring in research on medications that may be helpful, and just push and push and push until you get what you need to recover.Thanx for the pep talk. Im not good at pushing for my needs Unless Im angry and then they treat you as if your irrational. If you know what I mean. I just dont like being talked down to. It really pushes my buttons. Yes we have lots of issues.....I fully expect someone to respect my psychosis ;)
> I could certainly see how Ultram could trigger mania... why don't you tell your physician this and try a different narcotic? Tylenol #1-4 or codeine sulfate tablets (w/o acetaminophen) are very good and about as effective as Ultram; Vicodin, Vicoprofen, Norco, Anexsia, Lortab, Percocet, Percodan etc. are also quite similar in their pain-relieving effects.For some reason I cant tolerate hydro condone. Threw up all night last time I took it. But the oxycodone is the same as percocet. Ive tried to take it since for a paticularly bad back or fibro day and it makes my glands in my neck swell and my throat sore. I dont think I want to ignore those side effects.
The ultram is great for my fibro and I think my back will continue getting better with time, rest exercize..ect.. But the mania is killing me. So Ill see what the next doc says. If we add a mood stabilizer, I may be able to take it again.
the last pdoc i went to gave me neurontin, thinking it would help my fibro pain.
I dont like the increased mental fog. I have enough of that with fibro.
You seem fairly knowledgable about pharmacuticals.
Are Neurontin and Lamictal similar. One is anti siezure, the other anti convulsant. How Is that different?
> Good luck! :-)
Thanx!> Oh, believe me, I totally understand. I went through all 13 psychiatrists in my area, and now finally found one who is just incredible -- he'll listen to anything you have to say, he's never judgmental, and he's always open to new ideas. Unfortunately, his office is 50 miles away, lol.
How did you deal with docs that made you feel like rejecting their treatment plan indited you?
After 13 of them you must have pretty tough hide!
peace
Ima
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