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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by socialdeviantjeff on January 23, 2004, at 22:47:11
I know this has been done before but I am having a hard time. I stopped Effexor and Tegretol (tapering down both).
I'm still on Perphenazine and starting Lamictal.
I've been feeling like crap. I stopped the meds because of side effects. Now I have side effects and withdrawals. Smoking more than twice as mich as usual. I get floored about the simplest smallest things. My mood changes on a dime. crying more. anxiety coming back. Delusions and hallucenations worsening. Side effect-wise, I'm too tired to do anything at all. loads of cognitive and memory problems.
I feel like I'm constantly on the verge of doing something incredibly stupid, either to me, someone else, or something else. When these impulses come up, they are getting harder to fight, little by little. I can still supress the urges but it's tough. Outwardly, I do't show much (never have) but inside my head is like a big noisy carnival.
Sooo.. I'm afraid of calling my pdoc. I don't think he'll listen. My case is very complicated from bizarre drug reactions anyway. Just not sure what to do. At what point would it be good to consider admitting myself? For anyone who has been hospitalized, what was going on when you went in?
I'm not asking directly what do do, but I badly need some perspective. TIA
Posted by zeugma on January 23, 2004, at 23:30:59
In reply to When do you decide to go to the hospital?, posted by socialdeviantjeff on January 23, 2004, at 22:47:11
Well when I was hospitalized at 21 I was severely depressed, thinking about suicide a lot, unable to function in the outside world (i.e. hold a job) and considered alternately "lazy" (for not being able to work) and 'crazy" (for fighting with them over this issue and saying things like 'I wish I were dead right now'). Yes, and I was writing a lot of poetry, having dreadful spells of insomnia, and feeling a sense of total alienation.
The hospital was a safe place where razors were kept in a locked closet (I was thinking about slashing myself with a razor a lot, so I apppreciated this). I found some people I could relate to, much more than I've ever been able to find in the outside world. in a way i loved the place. But this was the late '80's when insurance plans were more generous and it wasn't unheard of for months to pass in a hospital.
I considered hospitalizing myself about four months ago while working with a CBT therapist.This, obviously, is not a testament to the effectiveness of CBT, at least not in my case.
Now, I'm depressed again, and up too late, and writing poetry, so who knows what will happen.
Posted by SLS on January 23, 2004, at 23:48:24
In reply to When do you decide to go to the hospital?, posted by socialdeviantjeff on January 23, 2004, at 22:47:11
Hi.
> I know this has been done before but I am having a hard time. I stopped Effexor and Tegretol (tapering down both).
What do you mean by saying that "this has been done before"? Done by you?
> I'm still on Perphenazine and starting Lamictal.
What's the game plan?
> I've been feeling like crap. I stopped the meds because of side effects.
There is often a cost versus benefit decision that must be made. Unfortunately, it might be a rough ride before you find an optimal treatment regime.
> Now I have side effects and withdrawals. Smoking more than twice as mich as usual. I get floored about the simplest smallest things. My mood changes on a dime. crying more. anxiety coming back.
Things might get worse before they get better, especially since it takes so long to titrate Lamictal to a therapeutic dosage. If you're lucky, you might see some preliminary improvements occurring at 50-75mg.
> Delusions and hallucenations worsening.
That's not cool.
Do you have psychotic depression? I know of someone who does very well with Wellbutrin, Neurontin, and Risperdal. She might have a bipolar thing going on with her. I guess that's why she is taking Neurontin.
I think you should speak to your doctor ASAP, and tell him that you have become seriously / severely depressed and are experiencing delusions and hallucinations. This is an urgent situation. I don't think perphenazine is particularly good for depression. It might be worth investigating Zyprexa or Risperdal for immediate relief and work from there. Probably Risperdal.
> Side effect-wise, I'm too tired to do anything at all. loads of cognitive and memory problems.
Those sound like symptoms of severe depression. I wouldn't place all the blame on the medication. The anxiety can certainly come from Effexor withdrawal.
> I feel like I'm constantly on the verge of doing something incredibly stupid, either to me, someone else, or something else. When these impulses come up, they are getting harder to fight, little by little.
If you were your own best friend, I bet you would do anything to convince your friend to get to the doctor IMMEDIATELY.
> Sooo.. I'm afraid of calling my pdoc.
Why?
> I don't think he'll listen.
I know it can be difficult to "impose" on your doctor. But I'm sure he would want you to call him/her.
> Just not sure what to do. At what point would it be good to consider admitting myself?
It sounds like you are getting close. If you are having suicidal or homicidal thoughts that are becoming overwhelming, you certainly need to speak to your doctor and let him help you decide what to do.
I wish you all the best.
- Scott
Posted by gardenergirl on January 24, 2004, at 9:16:16
In reply to Re: When do you decide to go to the hospital?, posted by SLS on January 23, 2004, at 23:48:24
Jeff,
I'm concerned about you. I'm sorry you have to go through all of this. Going to the hospital might just give you the support you need and perhaps a reduction in outside stressors to help you get through this. Do you know of a unit in a local hospital that you would consider? Do you feel you can speak with your pdoc about wanting more support through this, emphasizing you want to make the right decision? I know I would respect that in a client.Please take care of yourself, whatever your decision, and let us know how you are when you can.
gg
Posted by oskarsmom on January 24, 2004, at 14:54:39
In reply to Re: When do you decide to go to the hospital?, posted by gardenergirl on January 24, 2004, at 9:16:16
I have been hospitalized three times when I had plans to kill myself. In your case, I'd bypass calling the doc and go to the ER. That's what I do and other friends have done. I'm saying this mainly because of your delusions, hallucinations and impulses that you are having a hard time controlling. I wish you the best.
Posted by Mags on January 24, 2004, at 19:33:15
In reply to Re: When do you decide to go to the hospital?, posted by oskarsmom on January 24, 2004, at 14:54:39
I have gone to the hospital when the outside world has just gotten to be too much to cope with and it terrifies me and I was scared of what I would do to myself. YOu sound like you are at that point, or very close. If you are scared to talk to your doctor I would go straight to the hospital where there is a psych ward...it can be a haven, with others in the same boat to talk to with no outside pressures.That is what I have found when I needed to be there.
good luck.
Mags
Posted by Ilene on January 24, 2004, at 19:51:02
In reply to When do you decide to go to the hospital?, posted by socialdeviantjeff on January 23, 2004, at 22:47:11
How are you? What did you decide to do? I've never been hospitalized so I can't provide insight into the decision. Besides, you've probably made the call (or not) by now.
Having your pdoc not listen to you is [insert expletive of choice]. Mine does, but she hasn't prescribed anything to help my depression. She put me on Effexor, too. I lay in bed without moving for 3 days after I got off it. I had another week of brain zaps and dizziness.
BTW, I'm impressed by your ability to hold down a job. I haven't worked in years. I think you write well, too; I always read your posts.
Good luck,
Ilene
Posted by Karen_kay on January 25, 2004, at 11:09:16
In reply to When do you decide to go to the hospital?, posted by socialdeviantjeff on January 23, 2004, at 22:47:11
(((jeff)))
Did you get my card??? If not, check your email hun....Sorry it took so long to send it :(
I was hospitalized over the summer before my new medication was properly introduced and took effect. I tried to commit suicide. I even had my best friend over, as well as my sister when it happened. So, I couldn't say that I didn't have proper support at the time.
If things get to be too much, there is a time when you must say, "I have to go." And go. I know that I really look forward to your posts here, as do many others on this board. If the urge in your head gets too overwhelming, then go to the hospital. Maybe by going to the hospital, the doctors will be able to find the optimal medication that works for you. It's a possibility. And during my stay, it wasn't bad. Food, good stories, coloring, exercise time, great nurses. The list goes on and on. It could just be the break time that you've been needing to get things sorted out in your head and make the carnival stop, or at least make it fun again. Please Jeff, if it is overwhelming GO to the hospital!! OK??
Posted by CareBear04 on January 25, 2004, at 11:35:11
In reply to When do you decide to go to the hospital?, posted by socialdeviantjeff on January 23, 2004, at 22:47:11
Hey Jeff,
I've been where you are but never made the choice to go to the hospital. If I had, I probably could have avoided much longer and more unpleasant hospital stays. If you were to tell your doctor now that you feel unsafe and go into the hospital, it would probably be a fairly short stay while they figure out what meds work best for you. If, by chance, you hurt yourself and then end up in the hospital, the situation is much stickier, and you have much less say in your treatment. The hospital can be an okay place, especially if you're treated with respect... and, in my opinion, deciding that you need more help than you can give yourself is worth a lot of respect. Hope you feel better soon!> I know this has been done before but I am having a hard time. I stopped Effexor and Tegretol (tapering down both).
>
> I'm still on Perphenazine and starting Lamictal.
>
> I've been feeling like crap. I stopped the meds because of side effects. Now I have side effects and withdrawals. Smoking more than twice as mich as usual. I get floored about the simplest smallest things. My mood changes on a dime. crying more. anxiety coming back. Delusions and hallucenations worsening. Side effect-wise, I'm too tired to do anything at all. loads of cognitive and memory problems.
>
> I feel like I'm constantly on the verge of doing something incredibly stupid, either to me, someone else, or something else. When these impulses come up, they are getting harder to fight, little by little. I can still supress the urges but it's tough. Outwardly, I do't show much (never have) but inside my head is like a big noisy carnival.
>
> Sooo.. I'm afraid of calling my pdoc. I don't think he'll listen. My case is very complicated from bizarre drug reactions anyway. Just not sure what to do. At what point would it be good to consider admitting myself? For anyone who has been hospitalized, what was going on when you went in?
>
> I'm not asking directly what do do, but I badly need some perspective. TIA
Posted by helenag on January 25, 2004, at 13:13:32
In reply to When do you decide to go to the hospital?, posted by socialdeviantjeff on January 23, 2004, at 22:47:11
> I know this has been done before but I am having a hard time. I stopped Effexor and Tegretol (tapering down both).
>
> I'm still on Perphenazine and starting Lamictal.
>
> I've been feeling like crap. I stopped the meds because of side effects. Now I have side effects and withdrawals. Smoking more than twice as mich as usual. I get floored about the simplest smallest things. My mood changes on a dime. crying more. anxiety coming back. Delusions and hallucenations worsening. Side effect-wise, I'm too tired to do anything at all. loads of cognitive and memory problems.
>
> I feel like I'm constantly on the verge of doing something incredibly stupid, either to me, someone else, or something else. When these impulses come up, they are getting harder to fight, little by little. I can still supress the urges but it's tough. Outwardly, I do't show much (never have) but inside my head is like a big noisy carnival.
>
> Sooo.. I'm afraid of calling my pdoc. I don't think he'll listen. My case is very complicated from bizarre drug reactions anyway. Just not sure what to do. At what point would it be good to consider admitting myself? For anyone who has been hospitalized, what was going on when you went in?
>
> I'm not asking directly what do do, but I badly need some perspective. TIA
If you are still feeling this way today, call the doc or go to the hospital. They probably have an access center where you can be evaluated for admission.Having been in the hospital six times this past year, I can tell you that, if your gut tells you that you are not safe, you need to go in.
Here's hoping that the past couple days since you posted have been ones that have lightened your load. Helen
Posted by socialdeviantjeff on January 25, 2004, at 19:18:49
In reply to Re: When do you decide to go to the hospital?, posted by SLS on January 23, 2004, at 23:48:24
>
> What do you mean by saying that "this has been done before"? Done by you?
>
I guess what I meant was the "when to hospitalize" question has been done before. I'm just not much for lurking through the archives.> > I'm still on Perphenazine and starting Lamictal.
>
> What's the game plan?
>
Beats me. I think my pdoc may put me on Parnate.
>
> There is often a cost versus benefit decision that must be made. Unfortunately, it might be a rough ride before you find an optimal treatment regime.
>
Very true. For me the benefit has been a little more self-control. I'm still alive. The cost, though, has been tremendous as far as health and finances.>
> Things might get worse before they get better, especially since it takes so long to titrate Lamictal to a therapeutic dosage. If you're lucky, you might see some preliminary improvements occurring at 50-75mg.Hope so.
>
> > Delusions and hallucenations worsening.
>
> That's not cool.
>
> Do you have psychotic depression? I know of someone who does very well with Wellbutrin, Neurontin, and Risperdal. She might have a bipolar thing going on with her. I guess that's why she is taking Neurontin.
>
> I think you should speak to your doctor ASAP, and tell him that you have become seriously / severely depressed and are experiencing delusions and hallucinations. This is an urgent situation. I don't think perphenazine is particularly good for depression. It might be worth investigating Zyprexa or Risperdal for immediate relief and work from there. Probably Risperdal.
>
Thanks, however I'm allergic to both Wellbutrin and Neurontin (prozac too). I was getting some relief from the Perphenazine, but I think it's pooped out. I talked to my pdoc about Risperdal, but at the time the Perphnazine was working somewhat. Because of the reactions I've had, he's worried about TD. I will bring it up again with him. I do have psychotic depression.> > Side effect-wise, I'm too tired to do anything at all. loads of cognitive and memory problems.
>
> Those sound like symptoms of severe depression. I wouldn't place all the blame on the medication. The anxiety can certainly come from Effexor withdrawal.
>I definitely agree onthe anxiety. I reallycan't tell if the drugs I've tried have exascerbated the symptoms or if they sre actual side-effects. Probably both.
>
> If you were your own best friend, I bet you would do anything to convince your friend to get to the doctor IMMEDIATELY.
>
> > Sooo.. I'm afraid of calling my pdoc.
>
> Why?
>
> > I don't think he'll listen.
>
> I know it can be difficult to "impose" on your doctor. But I'm sure he would want you to call him/her.
>
> > Just not sure what to do. At what point would it be good to consider admitting myself?
>
> It sounds like you are getting close. If you are having suicidal or homicidal thoughts that are becoming overwhelming, you certainly need to speak to your doctor and let him help you decide what to do.
>
> I wish you all the best.
>
>
> - ScottThanks, Scott. I haven't been able to get a hold of him, but will try on Monday. I do appreciate your advice.
Posted by socialdeviantjeff on January 25, 2004, at 20:02:02
In reply to Re: When do you decide to go to the hospital? » socialdeviantjeff, posted by helenag on January 25, 2004, at 13:13:32
First I just want to thank everyone for your advice and kind words. Getting through this weekend would surely have been harder without you.
I've been trying to take it easier this weekend. I went to work and I guess I was so visibly (rare for me) disturbed that I was encouraged to go home. I didn't though, and somehow got through the night. Managed to keep my distance from customers, coworkers and walls for the most part. I also doubled my Perphenazine and that seems to have taken some of that edge off. Probably not the best idea, but oh well. I'm gona talk to my pdoc on Monday since I couldn't get a hold of him this weekend. Pretty concerned about that, though.To tell the truth, I'm worried about going. I have two options basically, one I think would be good but the other option is not so good. I'm worried about the disruption to my time with my daughter. Well, whatever happens, I thank all of you again for your advice and I'll let you know how it turns out.
Posted by lepus on January 25, 2004, at 20:04:56
In reply to Update., posted by socialdeviantjeff on January 25, 2004, at 20:02:02
(((((Jeff))))))
Posted by Pfinstegg on January 26, 2004, at 12:05:41
In reply to When do you decide to go to the hospital?, posted by socialdeviantjeff on January 23, 2004, at 22:47:11
Hi Jeff... I'm so sorry to hear what a rough time you are having. Psychotic depression is so tough to deal with. I don't know where you live (I feel it might be California, for some reason), but I was thinking that you might be interested in the trials of Mefipristone which are being carried out at Stanford and NIH. I believe they are for people with psychotic depression and high cortisol levels. Do you know what your cortisol levels are? They are reporting a 60% remission rate with seven-day mefipristone treatment. There is an old thread with more information on it which just got reactivated today- see above. (Mefipristone is misspelled "Mefipristole" Wishing you lots of luck,
Pfinstegg
Posted by Maxime on January 26, 2004, at 15:40:24
In reply to When do you decide to go to the hospital?, posted by socialdeviantjeff on January 23, 2004, at 22:47:11
Hey there. I'm sorry this is happening to you. But if you are having hallucinations, then it's time to go. I really think you should call your doctor though. I'm sure he/she would listen. Besides, if he can get you admitted immediately, it's better than going through the ER ... believe me.
Let us know what you decide to do.
Maxime
Posted by Sebastian on January 26, 2004, at 20:22:37
In reply to When do you decide to go to the hospital?, posted by socialdeviantjeff on January 23, 2004, at 22:47:11
Save yourself the trip and take some medicine. You might not find it so bad now that you have been off it for a while. It may help to take less than before, you might not need it now. Then go talk to the doctor about how bad the medicine was making you feel, and hopfully he/she will help you find a better medicine.
I went to the hospital when, I was standing in the snow with no shoes and falling over. they called an ambulence. They checked for physical problems then took me to the mental ward. I signed myself in.
Its not fun. You would be better off taking medicine if you can get away without all the personal attention. But the personal attention is nice sometimes. There were times I wanted to go back to the hospital just to hang out.
Sebastian
P.S. I've tapered my medicine many times after the hospital's. The same thing happened each time; I would feel worse than taking the medicine. Then I would act weird and freak everyone out. Eventualy I would start taking medicine again. And life would go back to normal.
Posted by socialdeviantjeff on January 26, 2004, at 22:49:46
In reply to Re: When do you decide to go to the hospital? » socialdeviantjeff, posted by Sebastian on January 26, 2004, at 20:22:37
Thanks again everybody.
Well, It's 9:30 MST and my pdoc hasn't called me back. I've been pretty numb today. Waaaay tired. I had the good fortune of catching a cold or something. I feel pretty ambivalant about the whole deal right now. I self injured last night but not too badly. I've made a deal with myself that I won't do it again for a while. I've decided that if things either don't improve or get worse by the end of the month I'm going regardless of what my pdoc does (or doesn't).
Posted by gardenergirl on January 27, 2004, at 6:42:41
In reply to update again, posted by socialdeviantjeff on January 26, 2004, at 22:49:46
Hang in there, Jeff. I hope your pdoc calls you back, but if not, please get some extra support. I'm thinking about you!
gg
Posted by Ilene on January 30, 2004, at 12:17:15
In reply to update again, posted by socialdeviantjeff on January 26, 2004, at 22:49:46
> Thanks again everybody.
>
> Well, It's 9:30 MST and my pdoc hasn't called me back. I've been pretty numb today. Waaaay tired. I had the good fortune of catching a cold or something. I feel pretty ambivalant about the whole deal right now. I self injured last night but not too badly. I've made a deal with myself that I won't do it again for a while. I've decided that if things either don't improve or get worse by the end of the month I'm going regardless of what my pdoc does (or doesn't).
Hi Jeff--I've been thinking about you quite a bit--one night I even dreamt of cuttlefish--isn't that romantic? I've tried to post a message to you several times but each time I delete it because it seems so lame. I decided I would go ahead and post a message anyway, what the hell.
So--here's hoping you're okay and getting the care you need. I think you're pretty cool for being able to work and maintain a relationship with your daughter, considering the raw deal you got.
Best of luck,
Ilene
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