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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Quintal on May 9, 2008, at 13:50:03
Dr. W (big pdoc) off sick again with a bad back. My social worker phoned him at home to ask for my other 7 zopiclone tablets and some lofepramine. He refused both, lofepramine because "it's not at all sedating". This is the same one that doesn't believe 5mg Zyprexa is sedating to any significant degree. He didn't suggest any alternative that might be helpful, but that wasn't the point - the point was to make me feel stupid and small for trying to suggest my own meds in the first place. I wanted lofepramine mostly for the antidepressant action. Any sedation that it might confer would be an added bonus. In my experience all tricyclics are sedating to some extent, although I agree (and knew when I suggested it) that lofepramine is the least sedating out of all of them. The reason I didn't suggest one of the more (profoundly) sedating TCAs such as amitriptyline or doxepin was that I don't want to be sedated well into the next day.
The BNF advises that lofepramine be taken at night, and I've only known them recommend this with antidepressants that are likely to make people feel sleepy. Activating antidepressants are given in the morning. When I was in hospital they were giving it to the opiate addicts that shared the ward (it was a joint psychiatric/detox unit), so I thought it might be helpful to me on that count too.
Pdoc's understudy has had to go back to Cyprus and will be gone for some time. So with Dr. W off on indefinite sick leave, the psychiatric outpatients clinic is basically closed until further notice. This is our golden opportunity to get to see Dr. B who gave me zopiclone and amisulpride in hospital, so this is what my social worker and I are planning to do. We're going to engineer a depressive crisis that requires urgent intervention so she has a reason to make an emergency appointment with Dr. B, who will hopefully agree to both zopiclone and lofepramine, or at least have some helpful ideas of his own.
Both my social worker and I hope Dr. W's back specialist is kinder and more merciful than himself. How awful if he were to get stuck with a such a selfish, ignorant bastard as himself. My inner sadist hopes he can't sleep at night either.
Q
Posted by cactus on May 9, 2008, at 17:27:54
In reply to More frustration with pdoc, posted by Quintal on May 9, 2008, at 13:50:03
How the hell can anyone tell you zyprexa isn't sedating, oohhh that makes me so mad. I'd love all pdoc's to be made to take 1 dose of either zyprexa, seroquel or zeldox/geodon and go to work the next day. If they managed to get out of bed, let alone drive, I doubt they'd make it to morning tea. The first dose of any AP knocks most people out cold for hours
I really feel for you because he's probably at home with a bottle of heavy duty pain killers and valium for back spasms.
frustration out.........
Posted by Quintal on May 9, 2008, at 18:08:46
In reply to Re: More frustration with pdoc » Quintal, posted by cactus on May 9, 2008, at 17:27:54
>How the hell can anyone tell you zyprexa isn't sedating, oohhh that makes me so mad.
I know! It goes to show how little he knows about the drugs he's prescribing.
>I'd love all pdoc's to be made to take 1 dose of either zyprexa, seroquel or zeldox/geodon and go to work the next day.
That is my fantasy too. I also wish they could be dragged out of their beds at night and carted off to a psychiatric ward to receive their first dose of medication (as part of their training). It would give them an idea of how terrifying it is for their psychotic patients to be hospitalized.
>If they managed to get out of bed, let alone drive, I doubt they'd make it to morning tea.
Dr. W assures me it's safe to drive on Zyprexa (he even checked in the BNF, and lo and behold it had no restrictions on driving), but benzos are too dangerous to be considered. From personal experience, the following night after taking 2.5mg Zyprexa I was trying to pack some groceries at the store and I was embarrassed to find my hands were moving so slowly that it made me look retarded. I think even the checkout girl noticed something was off. If I couldn't even pack carrier bags, how is possible that my reaction times would be fast enough for me to drive safely?
>The first dose of any AP knocks most people out cold for hours
They gave me a 10mg orodispersible wafer in hospital and I was in cloud cuckoo land for three days. One of the dinner ladies complained because I slept through Christmas lunch "You mean to say you've been in bed ALL DAY?!!!". What the bloody hell do you expect woman?! They slipped me a Mickey Finn for Christ's sake.
>I really feel for you because he's probably at home with a bottle of heavy duty pain killers and valium for back spasms.
Yeah, most likely. Wouldn't do to let 'one of the boys' suffers now would it? I'll bet there some sort of camaraderie among consultants.
Q
Posted by undopaminergic on May 9, 2008, at 20:15:55
In reply to Re: More frustration with pdoc » Quintal, posted by cactus on May 9, 2008, at 17:27:54
> The first dose of any AP knocks most people out cold for hours
>Not sulpiride, amisulpride, pimozide, and probably certain others.
Posted by Phillipa on May 9, 2008, at 20:47:28
In reply to Re: More frustration with pdoc, posted by undopaminergic on May 9, 2008, at 20:15:55
Driven for years on benzos most of my life. Bet he likes his drinks too. Phillipa
Posted by cactus on May 9, 2008, at 21:04:31
In reply to Re: More frustration with pdoc, posted by undopaminergic on May 9, 2008, at 20:15:55
> > The first dose of any AP knocks most people out cold for hours
> >
>
> Not sulpiride, amisulpride, pimozide, and probably certain others.Disclaimer, I was actually referring to the particular ones I mentioned. I didn't express myself properly. I should have made that statement clearer. Sorry about that generalization, I'm trying to rectify my expression with wording things correctly. I didn't mean it to read that way.
Posted by llurpsienoodle on May 10, 2008, at 9:22:51
In reply to Re: More frustration with pdoc » undopaminergic, posted by cactus on May 9, 2008, at 21:04:31
I was incredibly sedated on... seroquel 300mg (but the sedation went away after some weeks, as long as I got 9 hours of sleep at night.
Geodon, even at 60 mg was enough to knock me out for several hours, fortunately it has a shortish halflife, so that's not so crippling. At one point I was taking 240mg split into 4 doses, and I was totally non-functional. basically sitting on my rocking chair. I would have produced drool, but it required too much energy.
Zyprexa- I have a prn Rx for 10mg zyprexa zydis. I dissolves quickly and kicks in about 15-20 minutes later. It's for emergencies, like when I feel that reality is spinning, or when I feel like hurting myself so bad that tranquilizing and staying in bed is the only safe option...
which brings me to: (drum roll please!)
Abilify!!!! 3 cheers for abilify- it sedates for about 2-3 hours, it has nice calming properties, and it has gotten rid of my flashbacks for good. Even given recent gruesome real life stuff, it has treated me kindly and compassionately.
sorry to hijack thread.
now back to Q's dilemma
1) depressive crisis sounds like a very good plan.
2) your social worker sounds like a *star*
3) you have my undying sympathy. I really sincerely hope that you get some relief. You've been struggling for a while. I bet your dumb Bigpdoc only sees you as a psychotic recently emerged from the hospital, and doesn't bother getting to know your earlier functioning, or your personality (which is quite wonderful, believe it or not. I love your sense of humor)full disclosure: my wellbutrin has kicked in. I am in love with the world. Even with dr. Bob. (shock!)
(((((q))))))
-Ll
Posted by cactus on May 10, 2008, at 19:13:34
In reply to sedation and 2nd generation AP, posted by llurpsienoodle on May 10, 2008, at 9:22:51
> I was incredibly sedated on... seroquel 300mg (but the sedation went away after some weeks, as long as I got 9 hours of sleep at night.
>
> Geodon, even at 60 mg was enough to knock me out for several hours, fortunately it has a shortish halflife, so that's not so crippling. At one point I was taking 240mg split into 4 doses, and I was totally non-functional. basically sitting on my rocking chair. I would have produced drool, but it required too much energy.
>
> Zyprexa- I have a prn Rx for 10mg zyprexa zydis. I dissolves quickly and kicks in about 15-20 minutes later. It's for emergencies, like when I feel that reality is spinning, or when I feel like hurting myself so bad that tranquilizing and staying in bed is the only safe option...
>
> which brings me to: (drum roll please!)
>
> Abilify!!!! 3 cheers for abilify- it sedates for about 2-3 hours, it has nice calming properties, and it has gotten rid of my flashbacks for good. Even given recent gruesome real life stuff, it has treated me kindly and compassionately.
>
> sorry to hijack thread.
>
> now back to Q's dilemma
> 1) depressive crisis sounds like a very good plan.
> 2) your social worker sounds like a *star*
> 3) you have my undying sympathy. I really sincerely hope that you get some relief. You've been struggling for a while. I bet your dumb Bigpdoc only sees you as a psychotic recently emerged from the hospital, and doesn't bother getting to know your earlier functioning, or your personality (which is quite wonderful, believe it or not. I love your sense of humor)
>
> full disclosure: my wellbutrin has kicked in. I am in love with the world. Even with dr. Bob. (shock!)
>
> (((((q))))))
>
> -Ll
>
>
>
>Hi Li and Q. I think your plan of attack is fantastic too. Your social worker sounds like my GP. She is f**king awesome. It's just a shame she can't prescribe for you but at least people will listen to her when she is at your side. I wish you all the best and hope this gets sorted out immediately for you. All the best for a good outcome!!!!!!! CC
I put 2 C's because Li referred to my in plural once and I loved it. ;-)
Posted by llurpsienoodle on May 10, 2008, at 19:33:52
In reply to Re: sedation and 2nd generation AP, posted by cactus on May 10, 2008, at 19:13:34
(((cactii)))
if seeing your name in plural makes you happy, who am I to deny a friend such a simple pleasure?-Ll
Posted by undopaminergic on May 11, 2008, at 13:13:19
In reply to Re: sedation and 2nd generation AP, posted by cactus on May 10, 2008, at 19:13:34
You don't, by any chance, have a split personality? (A name in plural would seem particularly apt, then.)
This is the end of the thread.
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