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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 74. This is the beginning of the thread.
Posted by KaraS on August 3, 2005, at 0:12:05
I spoke to Dr. E. today. He said that my reaction to Klonopin was adverse and that it isn't going to be a good substitute for the doxepin. He now wants me to try the Dexedrine with the small amount of doxepin. Then I will meet with him next week and we'll take it from there.
In the meantime I went to the local drugstore today to get baseline figures for my blood pressure. It's a half of a mile walk to the drugstore. As soon as I got in to the store I took a reading. It was 99 over 70. Then I stayed in the store for about 15 minutes and took another test. That one was 94 over 73. Does exercise tend to raise or lower bp in general? I wonder if the readings would have been much different if i had driven to the store.
I'll take small amounts of the Dexedrine (open the 5 mg. capsule) and test out my blood pressure initially until I get to the 5 mg. mark.
Kara
Posted by med_empowered on August 3, 2005, at 3:19:41
In reply to Change of Plan - no Klonopin, posted by KaraS on August 3, 2005, at 0:12:05
hey! Too bad about your Klonopin experience. But...chances are, the doxepin+dexedrine combo will work just fine. If not, you always have other options. It sounds like you have an awesome doctor, by the way...how is the doc/patient relationship going?
Posted by KaraS on August 3, 2005, at 15:27:28
In reply to Re: Change of Plan - no Klonopin, posted by med_empowered on August 3, 2005, at 3:19:41
> hey! Too bad about your Klonopin experience. But...chances are, the doxepin+dexedrine combo will work just fine. If not, you always have other options. It sounds like you have an awesome doctor, by the way...how is the doc/patient relationship going?
Good so far. I find him to be very caring and dedicated. After the first meeting he gave me his cell phone number. He usually calls back within 24 hours too. He's also willing to think outside of the box and to treat aggressively. (He loves his work and he does it for that reason. He's well past the age that most doctors retire at.)
Posted by ed_uk on August 3, 2005, at 15:56:59
In reply to Change of Plan - no Klonopin, posted by KaraS on August 3, 2005, at 0:12:05
Hi K,
>94 over 73.....
Excellent. Dexedrine often produces a small increase in BP, this shouldn't be a problem in your case.
~ed xx
Posted by KaraS on August 3, 2005, at 17:08:57
In reply to Re: Change of Plan - no Klonopin » KaraS, posted by ed_uk on August 3, 2005, at 15:56:59
> Hi K,
>
> >94 over 73.....
>
> Excellent. Dexedrine often produces a small increase in BP, this shouldn't be a problem in your case.
>
> ~ed xxBut who knows. The last time I went to the doctor systolic was 127 by automatic monitor and 110 by manual a few minutes later. I guess I'll just have to keep testing it a lot to get an average and more of a full picture.
Do you happen to know if/how exercise effects blood pressure in the short-run?
K
xx
Posted by ed_uk on August 4, 2005, at 13:38:31
In reply to Re: Change of Plan - no Klonopin » ed_uk, posted by KaraS on August 3, 2005, at 17:08:57
Hi K,
>Do you happen to know if/how exercise effects blood pressure in the short-run?
AFAIK, it acutely increases BP. Of course, in the long run, regular exercise may help to reduce BP!
~ed xx
Posted by Ktemene on August 4, 2005, at 17:30:08
In reply to Re: Change of Plan - no Klonopin » ed_uk, posted by KaraS on August 3, 2005, at 17:08:57
> > Hi K,
> >
> > >94 over 73.....
> >
> > Excellent. Dexedrine often produces a small increase in BP, this shouldn't be a problem in your case.
> >
> > ~ed xx
>
>
>
> But who knows. The last time I went to the doctor systolic was 127 by automatic monitor and 110 by manual a few minutes later. I guess I'll just have to keep testing it a lot to get an average and more of a full picture.
>
> Do you happen to know if/how exercise effects blood pressure in the short-run?
>
> K
> xx
>Your blood pressure is terrific, Kara! Lots of people get an increase in blood pressure at the doctor's office, but even your highest systolic pressure, 127, is still extremely good.
Good luck with your change in meds!
Posted by KaraS on August 4, 2005, at 18:49:40
In reply to Re: Change of Plan - no Klonopin » KaraS, posted by Ktemene on August 4, 2005, at 17:30:08
> > > Hi K,
> > >
> > > >94 over 73.....
> > >
> > > Excellent. Dexedrine often produces a small increase in BP, this shouldn't be a problem in your case.
> > >
> > > ~ed xx
> >
> >
> >
> > But who knows. The last time I went to the doctor systolic was 127 by automatic monitor and 110 by manual a few minutes later. I guess I'll just have to keep testing it a lot to get an average and more of a full picture.
> >
> > Do you happen to know if/how exercise effects blood pressure in the short-run?
> >
> > K
> > xx
> >
>
> Your blood pressure is terrific, Kara! Lots of people get an increase in blood pressure at the doctor's office, but even your highest systolic pressure, 127, is still extremely good.
>
> Good luck with your change in meds!
>
Thanks. Not bad for 50, eh?I was thinking that maybe the machine at the drugstore was skewed too low but then I went back there last night with some friends. I wanted to take another measurement after I took a little bit of dexedrine. The systolic was up to 104 which still isnt bad. My three friends had ranges from 135 to 154 so I no longer think it's skewed too low. I'm pretty amazed actually since high blood pressure seems to run in both sides of my family.
k
Posted by KaraS on August 4, 2005, at 18:53:22
In reply to Re: Change of Plan - no Klonopin, posted by ed_uk on August 4, 2005, at 13:38:31
> Hi K,
>
> >Do you happen to know if/how exercise effects blood pressure in the short-run?
>
> AFAIK, it acutely increases BP. Of course, in the long run, regular exercise may help to reduce BP!
>
> ~ed xx
Thanks. I'll factor that in.I took a little bit of Dexedrine yesterday. I think I felt a little more energy from it. I'll try more soon but I am encouraged because I don't think it's going to put me to sleep like the Ritalin did. I'm cautiously optimistic.
Kara
xx
Posted by ed_uk on August 5, 2005, at 16:49:53
In reply to Re: Change of Plan - no Klonopin » Ktemene, posted by KaraS on August 4, 2005, at 18:49:40
>The systolic was up to 104 which still isnt bad.
LOL, it's really quite low.
~Ed xx
Posted by ed_uk on August 5, 2005, at 16:50:38
In reply to Re: Change of Plan - no Klonopin » ed_uk, posted by KaraS on August 4, 2005, at 18:53:22
Hi K!
>I'm cautiously optimistic.
That's great :-) How much do you think you took?
Ed xx
Posted by KaraS on August 5, 2005, at 22:50:26
In reply to Re: Change of Plan - no Klonopin » KaraS, posted by ed_uk on August 5, 2005, at 16:50:38
> Hi K!
>
> >I'm cautiously optimistic.
>
> That's great :-) How much do you think you took?
>
> Ed xx
Only a quarter of a .5 mg. capsule. Next time I'll take a half of a capsule.K
xx
Posted by ed_uk on August 6, 2005, at 10:02:23
In reply to Re: Change of Plan - no Klonopin » ed_uk, posted by KaraS on August 5, 2005, at 22:50:26
Hi K!
Good luck with 2.5mg, I hope it helps! :-)
~Ed x
Posted by KaraS on August 8, 2005, at 20:10:13
In reply to Re: Change of Plan - no Klonopin » KaraS, posted by ed_uk on August 6, 2005, at 10:02:23
> Hi K!
>
> Good luck with 2.5mg, I hope it helps! :-)
>
> ~Ed x
Thanks, Ed.I'll keep you posted!
K xx
Posted by tug_slug on August 9, 2005, at 19:29:29
In reply to Re: Change of Plan - no Klonopin » med_empowered, posted by KaraS on August 3, 2005, at 15:27:28
Your a very wise woman for not taking Klonopin. I stopped taking it 10 months ago and am still suffering.
Posted by KaraS on August 10, 2005, at 3:42:06
In reply to Re: Change of Plan - no Klonopin, posted by tug_slug on August 9, 2005, at 19:29:29
> Your a very wise woman for not taking Klonopin. I stopped taking it 10 months ago and am still suffering.
I think I replied to another post of yours on this topic on the withdrawal board. You quit cold turkey, didn't you?
Posted by Dr. Bob on August 10, 2005, at 19:59:46
In reply to Re: Change of Plan - no Klonopin » tug_slug, posted by KaraS on August 10, 2005, at 3:42:06
> I think I replied to another post of yours on this topic on the withdrawal board.
Sorry to interrupt, but I'd like to redirect follow-ups regarding Klonopin withdrawal there. Here's a link:
http://www.dr-bob.org/babble/wdrawl/20050712/msgs/532850.html
Thanks,
Bob
Posted by KaraS on August 10, 2005, at 22:09:02
In reply to Re: Change of Plan - no Klonopin » ed_uk, posted by KaraS on August 8, 2005, at 20:10:13
I took the 2.5 mg. yesterday. At first it seemed like I was really speeded up. I had palpitations and seemed more nervous. That could have been because I was nervous about taking it to begin with though. The odd thing is that it seemed to last forever. I took it at 8:00 pm which was dumb but I figured I'd be able to sleep by 4:00 am which is when I've been going to bed. I was wrong. I didn't fall asleep until 7:00 am. I didn't take any doxepin that evening though - I wanted to just see what the dexedrine itself would do. Even though I didn't take doxepin last night, there's still plenty in my system. Could the doxepin be making it last longer in my system?
Today I took 2.5 mg. again. I definitely had a faster heartbeat but I didn't feel any palpitations. I also felt like it was calming me down rather than being anxiogenic. I went to the drugstore and took my blood pressure. It was 106 over 70. It does seem to raise my pressure slightly but nothing to worry about at this point. However, my pulse rate was 99. I don't like it that high. It feels uncomfortable. If this gets worse as I increase my dosage then I'll probably have to start on a beta blocker as well.
K
Posted by alohashirt on August 11, 2005, at 7:21:17
In reply to Re: Dexedrine update, posted by KaraS on August 10, 2005, at 22:09:02
> I took the 2.5 mg. yesterday. At first it seemed like I was really speeded up. I had palpitations and seemed more nervous. That could have been because I was nervous about taking it to begin with though. The odd thing is that it seemed to last forever. I took it at 8:00 pm which was dumb but I figured I'd be able to sleep by 4:00 am which is when I've been going to bed. I was wrong. I didn't fall asleep until 7:00 am. I didn't take any doxepin that evening though - I wanted to just see what the dexedrine itself would do. Even though I didn't take doxepin last night, there's still plenty in my system. Could the doxepin be making it last longer in my system?
>
> Today I took 2.5 mg. again. I definitely had a faster heartbeat but I didn't feel any palpitations. I also felt like it was calming me down rather than being anxiogenic. I went to the drugstore and took my blood pressure. It was 106 over 70. It does seem to raise my pressure slightly but nothing to worry about at this point. However, my pulse rate was 99. I don't like it that high. It feels uncomfortable. If this gets worse as I increase my dosage then I'll probably have to start on a beta blocker as well.
>
> KI'm taking 30mg dexedrine in the morning with 100mg Toprol XL to reduce the hypertension this causes. You should keep monitoring it - I've found my BP can go allover when I take Adderall or dexedrine. Scary.
Posted by KaraS on August 11, 2005, at 12:52:13
In reply to Re: Dexedrine update, posted by alohashirt on August 11, 2005, at 7:21:17
> > I took the 2.5 mg. yesterday. At first it seemed like I was really speeded up. I had palpitations and seemed more nervous. That could have been because I was nervous about taking it to begin with though. The odd thing is that it seemed to last forever. I took it at 8:00 pm which was dumb but I figured I'd be able to sleep by 4:00 am which is when I've been going to bed. I was wrong. I didn't fall asleep until 7:00 am. I didn't take any doxepin that evening though - I wanted to just see what the dexedrine itself would do. Even though I didn't take doxepin last night, there's still plenty in my system. Could the doxepin be making it last longer in my system?
> >
> > Today I took 2.5 mg. again. I definitely had a faster heartbeat but I didn't feel any palpitations. I also felt like it was calming me down rather than being anxiogenic. I went to the drugstore and took my blood pressure. It was 106 over 70. It does seem to raise my pressure slightly but nothing to worry about at this point. However, my pulse rate was 99. I don't like it that high. It feels uncomfortable. If this gets worse as I increase my dosage then I'll probably have to start on a beta blocker as well.
> >
> > K
>
> I'm taking 30mg dexedrine in the morning with 100mg Toprol XL to reduce the hypertension this causes. You should keep monitoring it - I've found my BP can go allover when I take Adderall or dexedrine. Scary.
I will definitely monitor the bp carefully but at this point I'm more concerned with the tachycardia. That could change once I get to higher dosages. Do you take the regular dexedrine or the spansules?k
Posted by ed_uk on August 11, 2005, at 15:05:26
In reply to Re: Dexedrine update, posted by KaraS on August 10, 2005, at 22:09:02
Hi K!
>I didn't fall asleep until 7:00 am.......
LOL Kara, you should be taking the Dex at 7am!
>Could the doxepin be making it last longer in my system?
I never heard of that. It probably lasted a long time because you haven't developed any tolerance yet. The duration of action will probably decrease in time.
>It was 106 over 70.
That's really quite low! Well below average I'm sure.
>.......I'll probably have to start on a beta blocker as well.
Since you're asthmatic, verapamil could be a safer option than atenolol or bisoprolol. Verapamil might (possibly) increase the blood level of doxepin. You could try combining 12.5mg doxepin with Dexedrine and verapamil.
Ed xxx
Posted by KaraS on August 11, 2005, at 17:53:23
In reply to Re: Dexedrine update » KaraS, posted by ed_uk on August 11, 2005, at 15:05:26
> Hi K!
>
> >I didn't fall asleep until 7:00 am.......
>
> LOL Kara, you should be taking the Dex at 7am!
Yeah, that's the plan as soon as I can get myself on a more normal schedule!>
> >Could the doxepin be making it last longer in my system?
>
> I never heard of that. It probably lasted a long time because you haven't developed any tolerance yet. The duration of action will probably decrease in time.
OK. The Klonopin lasted a really long time too. I wonder if something in my system isn't working right?
> >It was 106 over 70.
>
> That's really quite low! Well below average I'm sure.
Yeah, I'm not worried about bp yet. If it goes up a lot as I increase dosage, then I'll worry but for now I'm not.
> >.......I'll probably have to start on a beta blocker as well.
>
> Since you're asthmatic, verapamil could be a safer option than atenolol or bisoprolol. Verapamil might (possibly) increase the blood level of doxepin. You could try combining 12.5mg doxepin with Dexedrine and verapamil.The thing is I've never been diagnosed as being asthmatic. I get allergic rhinitis and I can't breathe out of my nose. That, along with stress, can lead to panic and then I worry about breathing. I've never had weazing or passing out from it so it's probably not asthma. There's just a little part of me that isn't positive and so I worry about the Atenolol. I brought up the possibility of asthma with Dr. E but, as you know, he said not to worry about it with Atenolol.
I've never heard about Verapamil. I'll have to look into that more. I'll bring it up with Dr. E. and see what he thinks. Thanks!
I hate these medication trials!!!! I used to have a lot more patience with them but I'm sick of them now.
How are you doing btw? Are you able to study now on the Celexa?
> Ed xxx
K
xxx
Posted by ed_uk on August 11, 2005, at 18:03:37
In reply to Re: Dexedrine update » ed_uk, posted by KaraS on August 11, 2005, at 17:53:23
Hi K!
>I've never heard about verapamil.
It's a calcium channel blocker. It will slow your pulse and decrease your BP. It's used to treat hypertension and angina.
>How are you doing btw?
I feel quite good at the moment. I'm taking 80mg citalopram and it's pretty much eliminated my anxiety. I'm enjoying working at the pharmacy - it's my last day on Saturday. My exams are in two weeks though and I've done practically NO studying. If I fail any exams I'm going to take a year out of uni and work as a dispensing assistant for Rowland's - the pharmacy chain I'm working for at the moment.
~Ed xxx
Posted by KaraS on August 11, 2005, at 18:20:21
In reply to Re: Dexedrine update » KaraS, posted by ed_uk on August 11, 2005, at 18:03:37
Hi Ed!
> >I've never heard about verapamil.
>
> It's a calcium channel blocker. It will slow your pulse and decrease your BP. It's used to treat hypertension and angina.
Hmmmm. Might a calcium channel blocker induce depression? Or destabilize someone who is bipolar? Are there horrible side effects?
You know, I just took my pulse and it's at 80. It's been way too many hours to attribute that rate to the Dex. I guess that's been my resting rate lately. Even small amounts of stress seem to trigger an increase in my pusle rate. I think that the small amount of Dex probably wore off way before I realized it. Well, I just took 3.75 mg. so we'll see what that does. I shouldn't have any problems taking my thyroid medication (T4) with the Dex, should I?
> >How are you doing btw?
>
> I feel quite good at the moment. I'm taking 80mg citalopram and it's pretty much eliminated my anxiety. I'm enjoying working at the pharmacy - it's my last day on Saturday. My exams are in two weeks though and I've done practically NO studying. If I fail any exams I'm going to take a year out of uni and work as a dispensing assistant for Rowland's - the pharmacy chain I'm working for at the moment.
>
> ~Ed xxx
Sounds like a good plan. I thought you only had one left? I hope you don't fail any even though you might like the thought of working in the pharmacy for a year. I'm going to try not to ask you many questions so you can study. You will make a wonderful pharmacist someday. (You'd make a great pdoc too.)K
xxx
Posted by KaraS on August 11, 2005, at 19:55:54
In reply to Re: Dexedrine update » KaraS, posted by ed_uk on August 11, 2005, at 18:03:37
Hi again Ed,
I know I said I wasn't going to ask you many questions but I lied... :-)
I took the 3.75 mg. almost two hours ago. My pusle rate is now the same as it was before I took the Dex. It feels like it's higher though. I guess I'm more physically aware of my heart beating. I feel like I've just had a little bit of coffee along with a Valium - a little bit of tension along with more sedation. Sounds like a paradoxical response, doesn't it? I'm really bummed.
Kara
xx
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