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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 27. Go back in thread:
Posted by dbc on April 9, 2008, at 14:20:06
In reply to Re: Lorazepam » Quintal, posted by Phillipa on April 9, 2008, at 12:18:05
Lamictal and an Atypical is probably what the Pdoc will say instead. I never found Atypicals to be effective but i never flip into a normal mania just weird dysphoric episodes that present as insane panic attacks and general neurotic behaviour for days. So an anxyiolitic is pretty effective in my case, valium is a life saver.
Posted by Quintal on April 9, 2008, at 16:28:57
In reply to Re: Lorazepam » Quintal, posted by Phillipa on April 9, 2008, at 12:18:05
Thank you Phillipa. Yes, I'm officially bipolar. Had a manic episode and was sectioned back in December.
Q
Posted by Quintal on April 9, 2008, at 16:52:58
In reply to Re: Lorazepam, posted by dbc on April 9, 2008, at 14:20:06
Well if he does it's going straight in the bin. Pdoc's understudy already suggested olanzapine instead of lorazepam today, but my social worker refused because I've been on it twice before and she knows I hate it. We're both uneasy about the way atypicals are becoming the drugs of choice for long-term use in bipolar disorder. They have way too many serious side effects to be a reasonable option vs. benzos and mood stabilizers IMO. I suspect too often the profits of the pharmaceutical companies are being put before the welfare of patients these days. In any case, I've already taken Seroquel, Zyprexa, Abilify, flupentixol, and I'm on a low dose of amisulpride right now. I got no benefit from them - Abilify nearly drove me to suicide. Low-dose amisulpride has a mild mood-brightening effect in the short term, but it isn't helping very much. Zyprexa and Seroquel were just awful.
Lamictal worked quite well for two years, so that's why I'm considering it again. Parnate was the only antidepressant that really worked for me, although dothiepin was pretty good too, but they don't like to prescribe it any more, hence lofepramine if he doesn't want to prescribe an MAOI. When I was in hospital, lorazepam p.r.n and zopiclone were sufficient to treat my mania. I was on a low dose of amisulpride too, but that wasn't helping much - in fact I think it was making me slightly manic. Like flupentixol, I think it's one of the APs that can actually trigger mania in some people. Hypomania can be adequately treated with lorazepam or another benzo, if it needs treating at all. Atypicals are just overkill and I want nothing more to do with them.
Q
Posted by dbc on April 9, 2008, at 17:28:46
In reply to Re: Lorazepam » dbc, posted by Quintal on April 9, 2008, at 16:52:58
I hear you, i have a low dose of seroquel as needed and i hate the stuff. It causes weird effects for me even in low doses.
Lamictal is great at the moment. Its ironic though that whenever i titrate up a decent size dose it gives me stimulant effects that mimick mania for the first week or so. My dose was bumped to 300mg last week and thats the farthest im going despite my doctor insisting she has patients on 400 - 500mg. She's insane if she thinks im going on that much.
Posted by cactus on April 10, 2008, at 3:05:08
In reply to Re: Lorazepam » dbc, posted by Quintal on April 9, 2008, at 16:52:58
I agree Quintal, zyprexa and seroquel are the worst drugs I have ever been prescribed and compared to the side effects of benzo's I just can't comprehend why they keep pushing them on people.
I'll take benzo's for panic/mania etc.... ANYDAY!!!!!!!!!!!
I'll never touch an AP ever again, they make me worse, let alone fat and extremely obnoxious. I get very agitated on them and say and do things I'd never do normally. Paradoxical much!!!! Yet my stupid pdoc and GP at the time kept pushing them on me. I fired both of them and have never felt better.
Yeah benzo's are addictive, but do they cause massive weight gain, type II diabetes, irreversible TD? the list goes on. Drama.
I know thousands of people couldn't live without them and that they are a huge lifeline for them, giving them back their lives and returning them to a happy and stable life, but they are not for me.
Good luck with the lorazepam, I hope it helps
Posted by undopaminergic on April 13, 2008, at 2:58:56
In reply to Re: Lorazepam » Quintal, posted by cactus on April 10, 2008, at 3:05:08
> I agree Quintal, zyprexa and seroquel are the worst drugs I have ever been prescribed and compared to the side effects of benzo's I just can't comprehend why they keep pushing them on people.
>Those two, and many other drugs, are indeed overprescribed, but it's like fashion, and will change.
>
> I'll take benzo's for panic/mania etc.... ANYDAY!!!!!!!!!!!
>As long as it works, without repeated increases in dose, I see no problem with that, but things don't always work out so well.
>
> I'll never touch an AP ever again, they make me worse, let alone fat and extremely obnoxious.
>Antipsychotics are not all the same, and some of the problems are dose dependent. For example, I don't think I've used a drug with so few (none?) adverse effects as low doses of sulpiride.
>
> Yeah benzo's are addictive, but do they cause massive weight gain, type II diabetes, irreversible TD? the list goes on. Drama.
>Yes, for some reason, the medical establishment and indeed comtemporary society at large, is terrified of abuse, addiction and dependence to the point of absurdity. For example, for fear of addiction, they may rather risk causing stomach ulcers and liver damage with large doses of NSAIDs or paracetamol than use a modest and safe dose of opiates.
Posted by undopaminergic on April 13, 2008, at 4:12:46
In reply to Re: Lorazepam » dbc, posted by Quintal on April 9, 2008, at 16:52:58
>
> Parnate was the only antidepressant that really worked for me, although dothiepin was pretty good too, but they don't like to prescribe it any more, hence lofepramine if he doesn't want to prescribe an MAOI.
>Wby would they be opposed to dothiepin, if that has been used safely and effectively before?
>
> I was on a low dose of amisulpride too, but that wasn't helping much - in fact I think it was making me slightly manic. Like flupentixol, I think it's one of the APs that can actually trigger mania in some people.
>Yes, low doses of amisulpride are stimulating and generally inappropriate in anyone suffering from too much energy.
>
> Hypomania can be adequately treated with lorazepam or another benzo, if it needs treating at all. Atypicals are just overkill and I want nothing more to do with them.
>What calmed me down a few months ago when I was having my only hypomanic-like episode (with somewhat overwhelming enthusiasm and racing thoughts) so far was 5-hydroxytryptophan (5-HTP). Sertraline turned out to be overkill and more or less spoiled my "high".
Posted by cactus on April 13, 2008, at 4:54:58
In reply to Re: Lorazepam, posted by undopaminergic on April 13, 2008, at 2:58:56
> > I agree Quintal, zyprexa and seroquel are the worst drugs I have ever been prescribed and compared to the side effects of benzo's I just can't comprehend why they keep pushing them on people.
> >
>
> Those two, and many other drugs, are indeed overprescribed, but it's like fashion, and will change.
>
> >
> > I'll take benzo's for panic/mania etc.... ANYDAY!!!!!!!!!!!
> >
>
> As long as it works, without repeated increases in dose, I see no problem with that, but things don't always work out so well.
>
> >
> > I'll never touch an AP ever again, they make me worse, let alone fat and extremely obnoxious.
> >
>
> Antipsychotics are not all the same, and some of the problems are dose dependent. For example, I don't think I've used a drug with so few (none?) adverse effects as low doses of sulpiride.
>
> >
> > Yeah benzo's are addictive, but do they cause massive weight gain, type II diabetes, irreversible TD? the list goes on. Drama.
> >
>
> Yes, for some reason, the medical establishment and indeed comtemporary society at large, is terrified of abuse, addiction and dependence to the point of absurdity. For example, for fear of addiction, they may rather risk causing stomach ulcers and liver damage with large doses of NSAIDs or paracetamol than use a modest and safe dose of opiates.
>Very well said
Posted by med_empowered on April 13, 2008, at 14:02:26
In reply to Re: Lorazepam » undopaminergic, posted by cactus on April 13, 2008, at 4:54:58
I have a history of pretty substantial BZD abuse/misuse/whatever, but my current doc (who was my doc a couple years ago when I was obtaining BZDs through shady means and popping the hell out of them) is now OK w/ long-term use of Klonopin at a fairly standard dose (2mgs/day). He doesn't even hold my shady past over my head; basically, he understands that I need a BZD and I'll probably need one for a while.
I think you should either open up and be uber-open/transparent with your shrink, or get a new one. I think my open-ness and brutal honestly got my shrink to trust me enough to give me the Klonopin. I said I knew my history of drug abuse was a problem in Rx-ing a benzo, but I pretty much explained that Klonopin makes my life bearable and my days of misuse were over. I also offered to do drug testing, which I think was *KEY*: that really showed my shrink that I was all about getting better, not getting f*cked up...plus I think it might help on their end w/ liability issues.
Anyway, I hope this helps. Have you offered to do drug testing?
Posted by Quintal on April 13, 2008, at 21:09:22
In reply to Re: Lorazepam, posted by undopaminergic on April 13, 2008, at 4:12:46
>Wby would they be opposed to dothiepin, if that has been used safely and effectively before?
I noticed it's now on the BNF blacklist (along with MAOIs) as being 'less suitable for prescribing', citing the 'high rate of fatality' in what I suppose are dothiepin overdoses. It's the only TCA in the BNF that carries the 'less suitable for prescribing' warning symbol. I don't think this was the case back when I was 17. It used to be my GPs favourite antidepressant. It did actually cause problems with my heart - chest pains and palpitations, so I wouldn't be all that entheusiastic about going back on it, but it did work pretty well at the time.
http://www.bnf.org/bnf/bnf/55/3311.htm>Yes, low doses of amisulpride are stimulating and generally inappropriate in anyone suffering from too much energy.
The doses they were giving me in hospital did actually make me hypomanic, but one of the staff nurses came along with a 1mg lorazepam tablet to calm me down, because they'd noticed how energetic I'd been compared to Zyprexa... It was actually the lorazepam and zopiclone that was keeping me together in the hospital, but the pdoc and the staff did seem to see them as genuine medication - more like luxury items that I shouldn't ask for too often. Their preception of what was doing what was totally screwed. I saw zopiclone and lorazepam as the backbone of my medication regimen, wheas they just didn't seem to recognise them at all - in fact I was given home leave for two days without any, and I just didn't sleep; not only because I'd become mildly dependent on them and was suffering rebound insomnia and mild withdrawal symptoms, but because the amisulpride they *had* given me was still making me hypomanic, but now I was left for two days without anything to counteract it. I was very anoyed, putting it mildy. Could have been a recipe for disaster considering I'd been full-blown manic only weeks earlier.
Thank you, I will bear 5-HTP in mind for the next time I'm feeling hypomanic.
Q
Posted by kaleidoscope on April 14, 2008, at 15:28:48
In reply to Re: Lorazepam » undopaminergic, posted by Quintal on April 13, 2008, at 21:09:22
>I noticed it's now on the BNF blacklist (along with MAOIs) as being 'less suitable for prescribing', citing the 'high rate of fatality' in what I suppose are dothiepin overdoses.
That's it exactly. Dothiepin is a little bit too effective as a suicide drug. Ever such a lot of people still take it though - it was once the most widely prescribed AD in the UK - but not so many new patients are started on it.
Posted by Quintal on April 16, 2008, at 7:55:37
In reply to Re: Lorazepam » Quintal, posted by kaleidoscope on April 14, 2008, at 15:28:48
Ugh... how did I ever go to college on 4mg of this stuff?! Just took 1.5mg lorazepam before my dental appointment and now I feel... ugh.... I actually used to like feeling like this. I can hardly read, let alone type. Maybe why my grades were so poor? It's like a nerve block in my thinking parts. Might go and have a nap...
Q
Posted by undopaminergic on April 16, 2008, at 12:53:12
In reply to Re: Lorazepam, posted by Quintal on April 16, 2008, at 7:55:37
> Ugh... how did I ever go to college on 4mg of this stuff?! Just took 1.5mg lorazepam before my dental appointment and now I feel... ugh.... I actually used to like feeling like this. I can hardly read, let alone type. Maybe why my grades were so poor? It's like a nerve block in my thinking parts. Might go and have a nap...
>
> QI've always wondered why some people abuse sedatives, but I imagine they enjoy the relaxed state that remains after tolerance has developed to the sedation and sleepiness.
Posted by cactus on April 16, 2008, at 15:17:32
In reply to Re: Lorazepam, posted by Quintal on April 16, 2008, at 7:55:37
> Ugh... how did I ever go to college on 4mg of this stuff?! Just took 1.5mg lorazepam before my dental appointment and now I feel... ugh.... I actually used to like feeling like this. I can hardly read, let alone type. Maybe why my grades were so poor? It's like a nerve block in my thinking parts. Might go and have a nap...
>
> QWow Q, I had to take 5mg+ to get any relief with lorazepam, yet 5mg of valium or 1mg of clonazepam was fine. I also found 30mg of serapax(serax) did nothing either but most other benzos work well for me.
Even though I'm at 5mg of clonazepam at the moment, I'm on the way down to 4mg now. This high dose is not due to tolerance. It just staved off an episode late last year, it's combination of mood stabilization, anxiety/panic properties and restless leg symptoms have been fantastic for me, now I'm feeling better I'm tapering down from 6mg and feeling really good.
Posted by Phillipa on April 16, 2008, at 19:20:03
In reply to Re: Lorazepam » Quintal, posted by cactus on April 16, 2008, at 15:17:32
Q how long since you'd taken lorazapam til this dose? Phillipa
Posted by Quintal on April 17, 2008, at 18:16:27
In reply to Re: Lorazepam » Quintal, posted by cactus on April 16, 2008, at 15:17:32
It's probably because I'm not used to taking benzos during the day right now, but I have taken as much as 20mg clonazepam in a day. As you know, it's like getting blood from a stone here so I won't be getting any more any time soon. Only one tablet left. Will save it for emergencies.
Q
Posted by Quintal on April 17, 2008, at 18:17:07
In reply to Re: Lorazepam, posted by Phillipa on April 16, 2008, at 19:20:03
Almost six years.
Posted by Phillipa on April 17, 2008, at 21:29:13
In reply to Re: Lorazepam » Phillipa, posted by Quintal on April 17, 2008, at 18:17:07
Explains why it works for you. No other benzos? Love Phillipa
Posted by undopaminergic on April 17, 2008, at 23:01:00
In reply to Re: Lorazepam » cactus, posted by Quintal on April 17, 2008, at 18:16:27
> It's probably because I'm not used to taking benzos during the day right now, but I have taken as much as 20mg clonazepam in a day. As you know, it's like getting blood from a stone here so I won't be getting any more any time soon. Only one tablet left. Will save it for emergencies.
>
> QOne of the doctors I go to is very easy to get benzos (and some other sedatives) from. However, I assume you've already tried several different practitioners?
If course, it also depends on where you live. In this small "rat hole" of a town, there is only one, and sometimes two psychiatrists available. None of them are knowledgeable or resourceful, nor usually daring or self-confident enough to go along with my suggestions, so a lot of my treatments are entirely implemented by myself.
Posted by Quintal on April 18, 2008, at 7:41:14
In reply to Re: Lorazepam » Quintal, posted by Phillipa on April 17, 2008, at 21:29:13
I was taking clonazepam up until 2006, and I took Xanax for a short while last year.
Q
Posted by Phillipa on April 18, 2008, at 17:53:29
In reply to Re: Lorazepam » Phillipa, posted by Quintal on April 18, 2008, at 7:41:14
Q thought they didn't prescribe klonopin there? Love Phillipa
Posted by Quintal on April 18, 2008, at 18:50:37
In reply to Re: Lorazepam » Quintal, posted by Phillipa on April 18, 2008, at 17:53:29
Not unless they're asked. It's only licensed as an anticonvulsant in the UK.
Q
Posted by Phillipa on April 18, 2008, at 20:05:45
In reply to Re: Lorazepam » Phillipa, posted by Quintal on April 18, 2008, at 18:50:37
Q did you get as an anticonvulsant as 20mg is limit I think for klonopin for anticonvulsant. Love Phillipa
Posted by Quintal on April 19, 2008, at 7:28:31
In reply to Re: Lorazepam » Quintal, posted by Phillipa on April 18, 2008, at 20:05:45
No, for anxiety. The most I was prescribed was 8mg, the 20mg was off my own bat. Perhaps I was self-medicating a manic episode? Anyway, it didn't feel too good - blackouts and amnesia all the time.
Q
Posted by Phillipa on April 19, 2008, at 18:49:24
In reply to Re: Lorazepam » Phillipa, posted by Quintal on April 19, 2008, at 7:28:31
Q understand now. Love Phillipa
This is the end of the thread.
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