Shown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Peter on September 6, 2003, at 11:12:31
My pdoc is having me make 3 sweeping changes to my med regime, all at the same time.
I was taking 25mg adderall IR divided into 3 doses + 3.25mg klonopin, also divided into 3 doses.
The adderall, which I've taken many times before, was giving me too much mood lability this time, and I'm sick of keeping track of what dose to take when.
My general and social anxieties have been acting up rather badly lately.
So, my pdoc is having me do the following 3 things: start lexapro 5mg a day, Discontinue the adderall and switch directly over to Concerta 18mg, and reduce the klonopin by .25mg.
He has a habit of having me do a lot of changes at once, and we usually inevitably end up with me on a mountain of meds feeling like crap, and we have to taper each one so that, by process of elimination, he can figure out which is the 'culprit' med. But he is a great pdoc, so, even though this approach seems illogical to me, he probably has his reasons that go over my head.
Today is the first day I've made these changes, and I feel like the concerta 18mg is doing absolutely nothing; I'm totally lethargic, unmotivated, nauseaous, irritable, and my stomach is upset.
Which of these side-effects are from the lexapro or the Concerta? No idea.
Maybe the concerta 18mg feels like a sugar pill because I'm used to taking immediate release adderall. But, then again, I've taken adderallXR in the past and I felt its effects, though it wasn't as effective as the adderall IR's. My doc said he didn't know if I'd end up taking one or two 18mg concerta caps, and that we'd have to find out. I don't have much experience with ritalin.
But I don't know if these nasty SE's are due to TOO LOW a dose of concerta, or if I just don't respond to ritalin well. And then, of course, there's the question of the lexapro and how many of these SE's are coming from that. I guess I could eliminate any possibility that these feelings are coming from the .25mg klonopin reduction, since I just started the reduction today, and it has such a long half-life that I probably wouldn't feel it, if I feel it at all, until tomorrow. Also, I've only been on this high a dose of klonopin for about 2 weeks; my doc had me almost double my dose (used to take 2mg) to try to manage an acute anxiety episode I was going through back then.
Anyway, this really sucks. Anyone have any ideas?
thanks,
Peter
Posted by Jasmine Neroli on September 6, 2003, at 16:23:29
In reply to AGH! Help! 3 changes at once!!, posted by Peter on September 6, 2003, at 11:12:31
Hey Peter:
I'm guessing your nausea is from the Lexapro, cuz when I took Celexa (and it's so similar) I had nausea right away, plus abdominal pain. I ended up taking it at night so I wouldn't notice the effects. This was a persistent side effect for about 2 months, but after then I could switch back to an a.m. dose. Also, some people feel irritable when first on any SSRI, so the Lexapro might be the culprit there too, but I believe that's a pretty short-lived effect. I didn't get it on Celexa. As to your other symptoms, maybe it's still the high Klonipin dose causing the lethargy? You've had that all along, as I recall from our previous exchanges. Possibly the Concerta dose isn't high enough to counteract it yet, and you might notice a difference when your'e able to increase it??
Take Care.
Jas.
Posted by Peter on September 6, 2003, at 19:02:21
In reply to Re: AGH! Help! 3 changes at once!!, posted by Jasmine Neroli on September 6, 2003, at 16:23:29
> Hey Peter:
>Hi Jasmine.
> I'm guessing your nausea is from the Lexapro, cuz when I took Celexa (and it's so similar) I had nausea right away, plus abdominal pain. I ended up taking it at night so I wouldn't notice the effects. This was a persistent side effect for about 2 months, but after then I could switch back to an a.m. dose.
>2 months! whew! I keep forgetting about how nasty those acute SSRI SE's could get until I start one up again. I just gotta get thru these next 2 weeks or so - that's usually when the therapeutic effects start taking hold for me and the SE's decrease or become less bothersome.
As to your other symptoms, maybe it's still the high Klonipin dose causing the lethargy? You've had that all along, as I recall from our previous exchanges. Possibly the Concerta dose isn't high enough to counteract it yet, and you might notice a difference when your'e able to increase it??
> Yes, I agree. And I'm sticking with the plan to decrease the klonopin by .25mg as my pdoc said; I don't think that small decrease will cause withdrawal for me, considering I've only been on the higher dose for 2 weeks, and then I'll have a nice rounded 3mg daily dose. But I just don't think I want to be switching over to the concerta now and having to shuffle around trying to find the right dose of that while I'm at the same time undergoing these sucky lex SE's. I'd like to make each of these changes when I'm in as stable a state as possible. There is cause to switch from the adderall to concerta, as I mentioned, but at least I was beginning to feel more stable on the adderall by yesterday. And then today, when I replaced it with the 18mg concerta, it was like the floor gave way from beneath me. Maybe it's not a high enough dose, but also I'm dealing with a totally new stim, and it's possible I'm not reacting well to ritalin. I think I'd prefer to have to adjust to 1 new med at a time; I'm thinking of just going back on the 25mg adderall tomorrow and contacting my pdoc on Monday. Maybe he will agree on my holding off the switch to concerta until I'm thru this acute SE period from the lex; or, maybe he'll tell me to up the concerta dose. Either way, it seems logical for me to stick with the adderall tomorrow, as I am used to it, and at least I might be a bit functional tomorrow. Then I gotta just push on thru these lex SE's.
> Does that sound like it makes any sense? I don't even know; I feel like I can't think clearly.
thanks a lot,
Peter
Posted by Jasmine Neroli on September 8, 2003, at 0:38:58
In reply to Re: AGH! Help! 3 changes at once!! » Jasmine Neroli, posted by Peter on September 6, 2003, at 19:02:21
Yeah, you do make sense .I do know what you're saying! Starting several new things at once makes it very difficult to sort out what is causing what! At least you know what the Adderall does...so maybe you're right..stick to that whilst you're waiting for the Lex side eff. to settle. Everyone's so different, my daughter adjusted to Celexa within days, so I hope you adjust to the the Lexapro as quickly! Then you can exchange Concerta for the Adderall. And you might just find that, once the Lex kicks in, that Adderall will work better too in the combination ????
I just tried Effexor 75mg (in addition to the Klonopin, cuz my GP was nervous about returning depression), but I felt so zombie-like during the 4 days I was taking it, I stopped again today!! (Gotta go to work).Already, I feel less lethargic. I was worried about continuing with it, only to have to change later, and then go through the seemingly terrible "discontinuation" Effexor is famous for!!
I like Klonopin, but still feel "flat" on it. So I'm hoping when I get to see the PDoc, he'll let me augment it with Provigil or something a little activating.
Isn't it all so frustrating.....we're just guinea pigs, doing our own personal clinical trials??????
Don't you wish you had the ability to write your own prescriptions? Sometimes, I'd just like to go ahead and try something without having to discuss and listen and convince a doctor!!!!! I know it's dangerous etc.etc.etc. But, aaagh, the delays and waiting!
Good luck, as always!
J
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