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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 43. This is the beginning of the thread.
Posted by Phillipa on May 23, 2006, at 17:14:38
I saw the pdoc today and now he wants me to take the luvox l50mg and the valium 20mg and then add lamictal starting at 25mg and working up over 5weeks, pluse 80mg of Geodon. I don't want to take an antipsychotic what should I do? Love Phillipa
Posted by blueberry on May 23, 2006, at 17:42:07
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
Hey Phillipa, seeming as how I know a lot but at the same time can't seem to dig myself out of a hole, maybe my comments aren't worth anything. But, here goes...
Personally I would do one change at a time, starting with whatever you are most comfortable with. You are familiar with valium and luvox. If you don't want more luvox, then go for the lamictal and hold off on raising the luvox.
Lamictal I think is a decent choice. Being as safe as I am, I would start at 12.5mg for 4 days before going to 25mg. By safe I mean avoiding any kind of first day negative reaction or something due to too high of a dose that might scare you away from something that could have been really good. That's actually what I am doing myself and today is my first day (it went well). Lamictal seems to be an all around good med for unipolar, bipolar, anxiety, and schizophrenia with overall milder side effects than most psych meds. Mileage varies of course.
I agree with you about the antipsychotic, partially. That is, if there is going to be one, I personally would go with zypexa or seroquel. When geodon is good, it seems to be only for a very few people. On the other hand, zyprexa and seroquel work out well for many more people than geodon does. But I would certainly hold off on that until you had tried lamictal for 8 weeks or so, or until you quit, whichever comes first. You may find lamictal is all you need. I saw in one clinical study it was just as good as diazepam for anxiety. There might be some increased start up anxiety like most meds.
Just some opinions for thought.
> I saw the pdoc today and now he wants me to take the luvox l50mg and the valium 20mg and then add lamictal starting at 25mg and working up over 5weeks, pluse 80mg of Geodon. I don't want to take an antipsychotic what should I do? Love Phillipa
Posted by yxibow on May 23, 2006, at 17:45:03
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
> I saw the pdoc today and now he wants me to take the luvox l50mg and the valium 20mg and then add lamictal starting at 25mg and working up over 5weeks, pluse 80mg of Geodon. I don't want to take an antipsychotic what should I do? Love Phillipa
Tell him. No, its that simple, really. I know you've been through various medications and maybe he's trying to do augmentation therapy for your SSRI with an antipsychotic, which has proven successful for some anxiety and depression conditions otherwise not treated, but I don't understand why not just ramp up on the Luvox to 300 over a few weeks.
I take one because its necessary for my condition, at least at the moment, but Geodon is fairly powerful compared to Seroquel. Your doctor obviously is the only person in charge of writing scripts and being responsible for them for his medical license but you have a say in your treatment and you should go in to your doctor and tell him what you really feel. Stand up for yourself, Jan -- if you don't feel comfortable with a particular medication, say so. Does he have an email or a voicemail ? Leave a message that you're not comfortable, its that simple. The rest is between you and your doctor.
-- tidings
Jay
Posted by cecilia on May 23, 2006, at 19:12:57
In reply to Re: Saw PDoc Today What Should I Do? » Phillipa, posted by yxibow on May 23, 2006, at 17:45:03
Any doctor who would tell a patient to increase one drug and add two more at the same time (except in an emergency situation) is an idiot, in my opinion. Don't these doctor have any common sense?-obviously if you're changing several variables at the same time you have no idea what's causing what. Just say no, and consider finding another doctor. Cecilia
Posted by BrianBoru on May 23, 2006, at 20:23:10
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
By all means, if you don't want to take the anti-psychotic, don't. They are the most destructive of the psychiatric drugs. Just say no to psychotropic drugs !
Posted by Phillipa on May 23, 2006, at 21:00:39
In reply to Re: Saw PDoc Today What Should I Do?, posted by BrianBoru on May 23, 2006, at 20:23:10
Brian don't worry I'm taking the Geodon no way!!!!!Love Phillipa
Posted by Maximus on May 23, 2006, at 23:52:12
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
> I saw the pdoc today and now he wants me to take the luvox l50mg and the valium 20mg and then add lamictal starting at 25mg and working up over 5weeks, pluse 80mg of Geodon. I don't want to take an antipsychotic what should I do? Love Phillipa
Hi,
I think you really need them. Give them a try. You have nothing to lose.
Posted by Phillipa on May 24, 2006, at 0:00:37
In reply to Re: Saw PDoc Today What Should I Do? » Phillipa, posted by Maximus on May 23, 2006, at 23:52:12
Maximus why do I need Geodon? It's an atypical antipsychotic and I'm not psychotic. I can see the lamictal but I could get TD with geodon. So I'm not taking it Love Phillipa
Posted by Maximus on May 24, 2006, at 1:01:18
In reply to Re: Saw PDoc Today What Should I Do? » Maximus, posted by Phillipa on May 24, 2006, at 0:00:37
> Maximus why do I need Geodon? It's an atypical antipsychotic and I'm not psychotic. I can see the lamictal but I could get TD with geodon. So I'm not taking it Love Phillipa
I know you're not psychotic, but this cocktail could treat "all your symptoms" at once. Firt, i would go with a lower dose of Geodon. I find your pdoc very clever. No joke. He has his reasons to proceed like this. He knows you much better than we do, for sure.
Between you and me, you have nothing to lose. Isn'it? I'm sure you're able to trust your pdoc and be confident in your treatment. You might be surprised. Go slowly but surely. Keep us informed.
The decision belongs to you...
And... with all due respect for this board, keep always in mind that the FEAR is king here. Good luck.
Posted by valene on May 24, 2006, at 7:48:43
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
Phillipa,
I agree - I would *not* take an antipsychotic. Plus adding two more drugs at once puts up flag - not a good idea IMO.
Have you given up on trying EMSAM? You had said your pdoc would prescribe it for you. Love, Val
> I saw the pdoc today and now he wants me to take the luvox l50mg and the valium 20mg and then add lamictal starting at 25mg and working up over 5weeks, pluse 80mg of Geodon. I don't want to take an antipsychotic what should I do? Love Phillipa
Posted by B2chica on May 24, 2006, at 11:05:21
In reply to Re: Saw PDoc Today What Should I Do? » Phillipa, posted by Maximus on May 24, 2006, at 1:01:18
i don't know if your 'psychotic' or not, but there are certain reasons docs choose anti-psychotics, it doesn't necessarily mean your psychotic. but that doesn't mean you should blindly listen to him. if your scared of it TELL him/her. let them know you are REALLY hesitant, tell him why you are hesitant but ask them why they choose that drug for you? what symptoms do they think it will help and why.
but, i do agree with the others about the 'all at once'. i think the mixture and all at once is too much. if you get side effects you won't know what they're from and will have to stop all of them which could make things worse.
TELL him this. let him know that if you are willing to try some new meds/dosages that you will but you want to start slowly and one at a time.
my docs real big on this. it's important to see what works, how quickly and what sideeffects and that's hard to do if you mess with multiple new additions and dosage changes at the same time.i lik to keep something in mind when i go see any doctor. 1) they are a doctor for a reason, they did get the training and do have the clinical experience 2)however, they could have just as easily been a C student as an A student, we just don't know.
so i guess what i'm saying is trust a little but don't ignore your instinct. and if you ask questions and they refuse to discuss it with you RUN don't walk to the next doctor.best wishes dear Phillipa
b2c.
Posted by Crazy Horse on May 24, 2006, at 11:32:05
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
> I saw the pdoc today and now he wants me to take the luvox l50mg and the valium 20mg and then add lamictal starting at 25mg and working up over 5weeks, pluse 80mg of Geodon. I don't want to take an antipsychotic what should I do? Love Phillipa
Hey Sweetheart,
I say do what the Doctor recommends. Jan, he is the one who really knows the depth and severity of your illness. People here mean well, however it is my opinion that telling you to not take your meds as directed by your Doc is not only irresponsible, but also very dangerous! 10 different people "playing Doctor" telling you what to do is absurd...listen to the real Doctor who really knows what is going on with you. If you try the cocktail he has prescribed and you don't like the way it makes you feel, simply stop taking it and contact your Pdoc immediately. To not try something in the condition you are in, is going to keep you in that same condition indefinitely...and i don't think you want that. Try to trust your Pdoc, and if you don't, it's time to find a new one. I wish you only the best my friend.
Love, Monte
Posted by B2chica on May 24, 2006, at 11:39:06
In reply to Re: Saw PDoc Today What Should I Do? » Phillipa, posted by Crazy Horse on May 24, 2006, at 11:32:05
>>10 different people "playing Doctor" telling you what to do is absurd...listen to the real Doctor who really knows what is going on with you.
>>If you try the cocktail he has prescribed and you don't like the way it makes you feel, simply stop taking it and contact your Pdoc immediately.contradicting statements aren't they???
not trying to be mean...just an observation.
Posted by Meri-Tuuli on May 24, 2006, at 12:43:46
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
Hey PJ!!
Well, I'm not sure really what to recommend - I don't have personal experience with any of the meds!!
But have you got worse since your arm broke? If so, do you think that its because you've stopped jopping (if you have?) I don't know. I've read that stopping frequent aerobic exercise can lead to depressive syptoms.
Anyway sorry I can't be of any more help, but I'm definately here to wish you well and support you!!
But anyway, my mother in law takes valium, celexa, and zyprexa for severe anxiety issues.
Maybe just try the lactimal?
Anyway kind regards
Meri
Posted by Crazy Horse on May 24, 2006, at 14:01:56
In reply to Re: Saw PDoc Today What Should I Do?, posted by B2chica on May 24, 2006, at 11:39:06
> >>10 different people "playing Doctor" telling you what to do is absurd...listen to the real Doctor who really knows what is going on with you.
> >>If you try the cocktail he has prescribed and you don't like the way it makes you feel, simply stop taking it and contact your Pdoc immediately.
>
> contradicting statements aren't they???
> not trying to be mean...just an observation.
>Whatever B2Chica...or is that Dr. B2chica??? Wow, you are so impressive i just have to believe you must be a Doctor...just an observation.
Posted by B2chica on May 24, 2006, at 14:56:14
In reply to Re: Saw PDoc Today What Should I Do?, posted by Crazy Horse on May 24, 2006, at 14:01:56
i'm sorry if you are sensitive to my reply. i said i wasn't trying to be mean. my point was that you were being a little hard on everyone here saying they were 'playing doctor' when they were just giving their advice. that is the point of this board. i don't advocate 'playing' with your meds without physician assistance.
but that was my point. you mentioned that we were 'playing doctor' with our advice, however then you mentioned that if she didn't like the way it makes her feel she should just stop. this action could have harmful effects as well.
she should actually contact her doc immediately and seek professional advice as to how and when to stop.i am not a doctor nor do i play one on TV. and i certainly don't pretend to be one here.
i do not expect a reply from you, nor shall i reply further. if you do choose to reply, please try to be civil. i'm not trying to start an argument.b2c
Posted by Crazy Horse on May 24, 2006, at 17:40:27
In reply to Re: Saw PDoc Today What Should I Do? » Crazy Horse, posted by B2chica on May 24, 2006, at 14:56:14
You just hit a nerve i guess. I know Phillipa well and want what is best for her. My opinion is people who tell her not to listen to her Doc are saying they know better than her Doc. Only he really knows ( at least this is my hope) what meds may help her particular illness. We at PB cannot properly evaluate and diagnose someone simply by what we are told via internet communication...there may be a lot more going on than we are aware of, which is exactly why i suggested that she should comply with her pdocs instructions. Saying to stop taking the meds if she has a bad reaction may not of been the right thing to tell her, really what i was trying to point out was if it doesn't help or makes things worse, simply quit taking the meds...and you are right, call the Doc first. Some people are very vulnerable and impressionable to the point where the wrong advice to ignore there docs orders could be the difference from staying very ill or perhaps making a full or partial recovery.
Monte
Posted by Sobriquet Style on May 24, 2006, at 18:11:20
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
I wouldn't think its a good idea to start 2 different medications at the *same* time, otherwise you won't know which one is causing what side effects, and whether either one is working or not. Did your doc mention starting them all at once together?
Other than that, maybe an anipsychotic is what you truely need. Thats what that doctor suggested, if you don't try it, you'll never know. Perhaps you should follow his instructions and if it doesn't work, then knowledge is power as they say, to keep trying until something does work.
The Lamital stands a high chance of lifting your mood, its very good at that. It *may* increase anxiety at first, (it may not) but you have valium ~ I think.
Other than that, work with your doctor. Tiral and error until success. :)
~
Posted by madeline on May 24, 2006, at 18:21:33
In reply to Re: Saw PDoc Today What Should I Do? » B2chica, posted by Crazy Horse on May 24, 2006, at 17:40:27
In my opinion, you should have never left the office if your weren't absolutely sure why he was prescribing the medication and what side effects you should expect.
Crazyhorse is exactly right, PB is not a forum filled with physicians.
Just call him and if he isn't responsive, then find another pdoc.
Posted by Phillipa on May 24, 2006, at 18:31:08
In reply to Phillipa just call your pdoc., posted by madeline on May 24, 2006, at 18:21:33
To all of you wonderful people I have been trying all day to find a new pdoc but there are a limited number of them that are taking new patients or take medicaire. And I heard that if you say you will pay out of pocket they still won't take you. A PHD wanted on for Mother and even she couldn't get one for self pay. My decision as of now. No antipsychotic. I will raise the luvox starting from the l00mg to l25mg I did this last night. And then when I am used to that add what dose blueberry suggested of the lamictal l2.5mg. And pray he keeps prescribing the valium. After 30years you just can't go off them. And I agree with most of you who ever heard of adding three things at once you wouldn't know what was causing what. And my other option not good is to try and contact my old pdoc 4 hours away and see if she will prescribe the valium for me.She knows me and said I'm not psychotic I asked her once. This doc said he's leaning toward a diagnosis of bipolar. Don't know which one as I never feel high or even good. Love Phillipa
Posted by madeline on May 24, 2006, at 18:40:27
In reply to Re: Phillipa just call your pdoc. » madeline, posted by Phillipa on May 24, 2006, at 18:31:08
Sounds like a reasonable plan, but I would still contact your current pdoc and let him know what you have decided to do.
Be well
Maddie
Posted by Phillipa on May 24, 2006, at 18:43:02
In reply to Re: Phillipa just call your pdoc., posted by madeline on May 24, 2006, at 18:40:27
Since he doesn't talk to his patients on the phone I left a voice mail with his Rn. You can't talk to a real person anymore. Love Phillipa
Posted by Jost on May 24, 2006, at 19:43:30
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
I do think PDocs sometimes prescribe anti-psychotics for people who aren't psychotic. Are you seeing a therapist? If so, perhaps this doctor sees Geodon as a temporary measure, to help for a period of sorting through issues. At least, that would make sense to me.
However, as Monte says, you need to trust your doctor's opinion, because we can't know enough to give you really informed judgments.
Maybe there's a doctor in a community near yours, if you don't feel comfortable with this one?
Is the Luvox a drug you just started? You had said you''ve had trouble with SSRI's. Has luvox caused fewer side-effects so far than others?
Jost
Posted by Phillipa on May 24, 2006, at 19:48:52
In reply to Re: Saw PDoc Today What Should I Do?, posted by Jost on May 24, 2006, at 19:43:30
Jost no I've taken low dose luvox for a long time and it's the only one I seem to be able to tolerate. l0yrs ago it worked for me at 250mg. Then it stopped so more AD's About a year since I've been back on the low from 25=50mg. Love Phillipa
Posted by Maximus on May 24, 2006, at 20:18:46
In reply to Re: Saw PDoc Today What Should I Do? » Jost, posted by Phillipa on May 24, 2006, at 19:48:52
It's a shame that Crazy horse and i have been the only ones to suggest to be compliant with her pdoc. No wonder why so much people here become resistant to treatment.
Wishing all the best to Philippa.
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