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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by garcia cortez on July 25, 2008, at 21:15:40
My daily medications: Risperdal 8mg; Seroquel 100mg; Klonopin 10 mg; Xanax 4mg; Ambien 10mg; Remeron 30mg. My present psychiatrist is also an addiction counselor and says my meds are fine for my condition (Schizophrenia--paranoid type, OCD, and temperal lobe epilepsy). What are the chances that my next psychiatrist will renew these meds as there is an ideological bias against benzodiazapines? I am in relative remission with these medications and can function socially ect.
Posted by yxibow on July 26, 2008, at 16:35:20
In reply to meds and next psychiatrist, posted by garcia cortez on July 25, 2008, at 21:15:40
> My daily medications: Risperdal 8mg; Seroquel 100mg; Klonopin 10 mg; Xanax 4mg; Ambien 10mg; Remeron 30mg. My present psychiatrist is also an addiction counselor and says my meds are fine for my condition (Schizophrenia--paranoid type, OCD, and temperal lobe epilepsy). What are the chances that my next psychiatrist will renew these meds as there is an ideological bias against benzodiazapines? I am in relative remission with these medications and can function socially ect.
Whether there's an ideological bias against benzodiazepines, if you have epilepsy, you are warranted to be taking that dose of Klonopin.Its just there may be several questions -- typically combining APs is not the best thing because there is no way of predicting what it will do.
The same applies for combining benzodiazepines -- the doctor may question the reason for having an extra 4mg of Xanax on board when you are already soaked (pardon the term) in Klonopin. Again some doctors don't like combining benzodiazepines.
I'm not too clear though in the above comments as to why there would be a new doctor -- are you moving to a different area, or is your doctor retiring or something?If you're stabilized and in "relative remission" which is what we all can expect from medication I also would concur with your psychiatrist that he is practicing evidence based psychiatry.
If you are in a new situation for a psychiatrist, if he feels that the benzodiazepines are too much for you he may want you to consult with a doctor to use a present generation AED such as Depakote or the like for your epilepsy, this may also help anxiety.But there is also evidence (I am not schizophrenic but I have some symptoms that could be described very loosely as a psychosis -- remembering that a psychosis doesn't mean what people think of the word.) that high dose Valium can be just as effective for treating Schizophreniform disorders. So you may be able to keep your benzodiazepines on board.
Also psychiatrists really tend to not like to tinker or interfere with things out of their scope of practice -- and if the Klonopin you have been taking for a while is for epilepsy, I don't think he/she.....
....provided they're providing good medical practice would want to move it unless you're experiencing say, complete memory loss, accidents, tripping and falling all the time, from benzodiazepines, because it could cause an epileptic episode.
I hope that helps
-- tidingsJay
Posted by garcia cortez on July 26, 2008, at 19:30:19
In reply to Re: meds and next psychiatrist » garcia cortez, posted by yxibow on July 26, 2008, at 16:35:20
The Xanax and the Ambien have been added because ALL Antidepressives cause hypomania and I cannot sleep. I trialed the SSRI's the tricyclics, trazadone lexapro Lamictal ect. and Remeron is the only one that causes the least amount of hypomania (over 30 mg causes outright mania as did Lexipro). I have been dianosed with manic depression in the 1970's but was later re-diagnosed with schizophenia due to hallucinations/delusions of megalomania and paranoia, flat affect ect. ( psychological testing reafirmed the schizophenic-paranoid subtype dianosis). The temperal lobe epilepsy was confirmed by EEG during multiple sleep studies that found intermmitant leg jeking that was causing up to 30 awakenings an hour (thus the Xanax and Ambien). The university hospital also had an neruo-psychopharmacologist review the medications and he said they were OK given my particular symtoms. I may be moving out of state so this would be the reason for getting a new psychiatrist (I also see a Psychologist 2X a month and a psychiatric nurse once a month to "explain away" phisical syptoms (hypochondria type delusions [ie. she says a person cannot feel one cell changing into a cancer cell, even though I think/feel I can; there are endless types of delusions/ obsessions of getting infected , ill ect.]). So I worry I will not get the medication I need from a new psychiatrist and will go back to that insomnic state that makes my schizophina ten times worst. I Will revert back into an unfunctional state(as I was before the XANAX and AMBIEN.
Posted by Sky Brite Line on July 26, 2008, at 23:55:30
In reply to Re: meds and next psychiatrist » garcia cortez, posted by yxibow on July 26, 2008, at 16:35:20
Is Xanax helping? well i was on Klonpoin for a long time. ZYPREXA would be great, but it causes weight gain.
Posted by garcia cortez on July 27, 2008, at 3:17:53
In reply to Re: meds and next psychiatrist, posted by Sky Brite Line on July 26, 2008, at 23:55:30
Yes the Xanax stops the jerking of my legs to the extent that I can fall asleep and the Ambien prolongs the effects of the Xanax (according to my psychiatrists [during the medicine trial stage I had 3 psychiatrists and one neurologist working as a team until I achieved functionality socially]) so that I do not have "early morning awakenings" and get 7 solid hours of sleep now. This team approach allowed me to get the medical tests needed to figure out why I was a chronic insomniac. They also said that I had a condition called "oneirophenia" which means a hallucinatory dream like state caused by sleeplessness. They predicted that if the insomnia was treated it would allow the antipsychotics to work as they should and my symptoms would be controlled to a point where my psychotic and social isolation symptoms would lift to allow functioning--and they were right! This is the "upside" to being treated by a research hospital w/ a team approach. They also are not bound by rigid-by-the-book politically correct treatments and it is common to see patients treated with very unconventional combinations/dosages of medications. The down side of research hospital treatments is all too well known.
Posted by amazing grace on July 27, 2008, at 23:23:08
In reply to Re: meds and next psychiatrist » Sky Brite Line, posted by garcia cortez on July 27, 2008, at 3:17:53
10mg klonopin, 4mg xanax, 10mg ambien, 30mg remeron, 8mg risperdal and 100mg of seroquel seem like a lot of medications to have around especially when someone has depression. Just your benzos are 420mg a month. I've read that 90 or so mg of klonopin can be a lethal overdose--depending on ones weight. The ambien another 300mgs. I would think that some doctors will be afraid of prescribing these numbers of sedatives. Wherever you are moving to, a new doctor will want all of your medical records, so it would be a good idea to have them on hand so that you do not run out of your essential meds. Take care not to accidentally overdose!! I am aware that schizophrenics are routinely given heavier dosages of meds and are used to having lots of meds around but take care nonetheless. Good Luck when you move!!!
Posted by Abby Cunningham on July 28, 2008, at 11:09:51
In reply to meds and next psychiatrist, posted by garcia cortez on July 25, 2008, at 21:15:40
This answer may seem simple, but can't your current psychiatrist write a letter on his letterhead, stating the reasons why you are taking these medications and that in his opinion, they are the best combination for you? Just a thought.
best,
Abby
Posted by garcia cortez on July 28, 2008, at 15:44:39
In reply to Re: meds and next psychiatrist » garcia cortez, posted by amazing grace on July 27, 2008, at 23:23:08
My insurance company requires maintenance mediations to be bought at their wholesale mail order pharmacy. They require a 3 month supply to be prescribed.
So I am sent every three months:
Konopin 450 tabs @ 2mg each = 900mg;
Xanax 360 tabs 1mg each =360mgs;
Ambien 90tabs @10mg each=900mg;
Risperdal 360 tabs @ 1mg each =360mg;
Seroquel 90 tabs @100mg each = 9000mg;
Remeron 90 tabs @30mg each =2700mgs.
They have been sending them for a decade this year and not once have they called my psychiatrist to confirm the dosages.
I imagine since they deal with the entire U.S. they see these dosages often enough to seem commonplace.
I take it that my psychiatrist trusts me enough to allow for these medications to be left in my own responsibility.
Posted by garcia cortez on July 28, 2008, at 15:47:16
In reply to Re: meds and next psychiatrist » garcia cortez, posted by Abby Cunningham on July 28, 2008, at 11:09:51
Yes I think this is a reasonable way to go about it. Thank you for the idea.
Posted by garcia cortez on July 28, 2008, at 16:33:21
In reply to Re: meds and next psychiatrist » garcia cortez, posted by Abby Cunningham on July 28, 2008, at 11:09:51
> This answer may seem simple, but can't your current psychiatrist write a letter on his letterhead, stating the reasons why you are taking these medications and that in his opinion, they are the best combination for you? Just a thought.
>
> best,
> AbbyWhat a good idea! I will see if my Doc would write a letter for me. Thanks.
Posted by amazing grace on July 30, 2008, at 14:08:35
In reply to Re: meds and next psychiatrist, posted by garcia cortez on July 28, 2008, at 16:33:21
WOW!! your doctor must really trust your state of mind!! Happy to see that there are still some good Doctors out there. My mother is a diagnosed paranoid and at age 83 is also on two anti psychotics (trilaphon and risperdal) and two anti depressives (elivil and paxil), in addition to 6mgs xanax and 15 mg ambien. She is also on namenda (even thought see had no plaques revealed on her mri). This cocktail was good enough for her to be non psychotic and not depressed but she still could not function well socially ( she is a shut in). Perhaps some klonopin would made her socially functional, as you are now. I'll bring a copy of this thread to her doctor and maybe she will benefit from the addition of klonopin.
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