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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 33. This is the beginning of the thread.
Posted by Christ_empowered on August 16, 2011, at 14:21:41
so yeah, that's my shrink's plan. Get the Lamictal to 200, get the Abilify down to 15. What do you all think? I just started the Lamictal, so I'm on 25 right now; I won't be at 200 for about 1 month.
Posted by sigismund on August 16, 2011, at 14:26:55
In reply to lower Abilify, raise Lamictal, posted by Christ_empowered on August 16, 2011, at 14:21:41
Can you do it in such a way that you don't do both at once?
So you know what is doing what?
Posted by floatingbridge on August 16, 2011, at 15:38:45
In reply to lower Abilify, raise Lamictal, posted by Christ_empowered on August 16, 2011, at 14:21:41
> so yeah, that's my shrink's plan. Get the Lamictal to 200, get the Abilify down to 15. What do you all think? I just started the Lamictal, so I'm on 25 right now; I won't be at 200 for about 1 month.
This is what you wanted, yes? I'm glad he's on board and will be keeping an eye on the transition.
How will you do this to achieve maximum stability? What dose of Abilify will you be at while the lamictal ramps up?
Hope this works. Sounds like it could be real nice for you.
Fingers crossed.
Posted by Phillipa on August 16, 2011, at 16:36:02
In reply to Re: lower Abilify, raise Lamictal » Christ_empowered, posted by floatingbridge on August 16, 2011, at 15:38:45
CE here's wishing you luck. True what you wanted is this a better pdoc than other or the same one? Phillipa
Posted by Christ_empowered on August 16, 2011, at 17:03:55
In reply to Re: lower Abilify, raise Lamictal, posted by Phillipa on August 16, 2011, at 16:36:02
This is my second public health psychiatrist. I moved back in with my parents (I'll soon have my own place nearby), so I got a new doctor. She's great. Its public health, which around here=no controlled substances, but that's OK.
What I'm trying to do is keep this agitation at a minimum, avoid florid psychosis+mania, and also avoid that over-tranquilized, dulled out, apathetic "tranquilizer psychosis" (as Orthomolecular doctor Dr.Hoffer called it). I think this could be a good plan to get where I need to go in terms of avoiding side-effects but also avoiding a mental hospital.
The plan is to keep the Abilify @ 30 until the Lamictal hits 200, then start taking 1/2 tablets. By then, I imagine the Lamictal will be at a sufficient dose to keep some of the agitation and mood instability at bay, and the Abilify dose will still be high enough to stop psychosis.
It remains to be seen if I'll need more medication. My social phobia has been intensifying lately, which sucks, as have those pesky flashback voices (not so much "psychosis" as reliving the experience of constantly being made fun and talked about a few years back). I don't know if medication is appropriate for such a thing, or if additional medication would even be needed, but if this continues, I might need to do something.
Posted by sigismund on August 16, 2011, at 17:47:32
In reply to Re: lower Abilify, raise Lamictal, posted by Christ_empowered on August 16, 2011, at 17:03:55
>(not so much "psychosis" as reliving the experience of constantly being made fun and talked about a few years back). I don't know if medication is appropriate for such a thing, or if additional medication would even be needed, but if this continues, I might need to do something.
There is nothing strange about that. Things that happened to me 50 years ago are constantly with me, as you would expect. It is good to let go of these things if you can, but I don't know how you do that.
Posted by Phillipa on August 16, 2011, at 21:36:15
In reply to Re: lower Abilify, raise Lamictal, posted by Christ_empowered on August 16, 2011, at 17:03:55
CE yes know exactly what you are talking about from our correspondences. I seriously would make no changes til you stabalize. I don't want to see you hospitalized again either. You were stable til moving back correct? Has there been a recent trigger? Love Phillipa
Posted by floatingbridge on August 16, 2011, at 22:21:36
In reply to Re: lower Abilify, raise Lamictal, posted by sigismund on August 16, 2011, at 17:47:32
> >(not so much "psychosis" as reliving the experience of constantly being made fun and talked about a few years back). I don't know if medication is appropriate for such a thing, or if additional medication would even be needed, but if this continues, I might need to do something.
>
> There is nothing strange about that. Things that happened to me 50 years ago are constantly with me, as you would expect. It is good to let go of these things if you can, but I don't know how you do that.
Oh dear. Tis true for me. Some stuff just sticks.Sorry CE.
Posted by Christ_empowered on August 17, 2011, at 0:22:10
In reply to Re: lower Abilify, raise Lamictal » sigismund, posted by floatingbridge on August 16, 2011, at 22:21:36
you know, its strange. All this stuff that I went through didn't bother me as much while I went through it. I think I was so burned out and dulled out--which I think may have been a survival mechanism, because if I'd been more aware and alert, I probably would have offed myself--that it didn't phase me.
Now, it does. I should've asked my shrink for an antidepressant or something, but I'm not in full-on crisis mode. I do seem crazy, though; I pace around the house. I even grabbed my head out of frustration with the voices. And its not like I think the FBI is out to get me or anything--these voices are directly related to my life experiences.
In terms of meds, what are my options? I'm on 30 Abilify and 25 lamictal (working up to 200, assuming I don't get The Rash). Celexa worked OK @ 20mgs for a while, but I hate how SSRIs make me feel.
Do you think I should just wait out the Lamictal increase (and the decrease in Abilify to 15) and see how I feel?
I really should have talked to my doctor today. I just didn't know what to say, and my mood improved so much during our session. I also didn't want to make too many medication changes so soon. I mean, I'm no shrink, but couldn't Lamictal+an antidepressant=trouble, even on Abilify? Ugh. I just don't know. You'd think that an anti-*psychotic* would, you know...stop *psychosis*, wouldn't you?
Maybe pills aren't even the answer. I'll be seeing a counselor in about a month. We'll see.
Posted by floatingbridge on August 17, 2011, at 8:55:36
In reply to silencing the voices in my head, posted by Christ_empowered on August 17, 2011, at 0:22:10
> you know, its strange. All this stuff that I went through didn't bother me as much while I went through it. I think I was so burned out and dulled out--which I think may have been a survival mechanism, because if I'd been more aware and alert, I probably would have offed myself--that it didn't phase me.
>
> Now, it does. I should've asked my shrink for an antidepressant or something, but I'm not in full-on crisis mode. I do seem crazy, though; I pace around the house. I
even grabbed my head out of frustration with the voices. And its not like I think the FBI is out to get me or anything--these voices are directly related to my life experiences.CE, I tend to look through a PTSD lens. One may look crazy, jumping out of a car, running down the street, hiding or cowering. I've banged my own head so hard that I
scared myself. I have also become increasingly agitatedly depressed in the past, ruminating upon things that had happened that were harmful or violating. I looked 'crazy'. Truthfully, I was not well, but I was not psychotic either because the thoughts were about real life events, some ugly exchanges with people. And I could not let them go. I wfelt like a haunted house full of ghosts. I isolated myself unable to read, watchna film, or listen to music, because anything touched upon the pain of being hurt, humilated, invalidated, reduced, nearly obliterated. I began to believe I was like the dead. (but not really dead, though it began to seem like a viable option.) Maybe this brings me close to psychois. I don't know.You actually experience the thought process as voices that are audible? Yet you say in your head. So you know the difference. And this is maddening but different? And reality based, yes? CE, the bit you have shared on the board has led me to think to myself that you have taken some pretty unfair hits. Trauma as a word tends to be overused, but it basically means 'open wound'.
These things, these hurst and unjustices are best treated, the model goes with medication plus therapy. True, lexapro muted those voices for awhile to whispers, but they came back.
Coming clean with the doc would have been good, but how to do that. In some ways it might be easier to say the FBI is after me than I was hit on the head or socially humiliated and couldn't find a way to fight back. That would be revealing the vulnerability. So I understand.
Is there away to call back and reschedule to explain this. Many care providers, ESP public ones are aware their clients fit the criteria for a PTSD comorbidity. Maybe you can get that counseling session moved up, too. Or find some good crisis counseling.
An antipsychotic can't really be expected to stop what is really a sort of lucidity. It (risperidone) failed to stop PTSD symptoms in most combat vets.
If the amount of agitation you feel isn't being addressed, I suggest you check in with your doctor again and see what her suggestions are. She may be able to fast track your appointment or secure interim counseling.
>
> In terms of meds, what are my options? I'm on 30 Abilify and 25 lamictal (working up to 200, assuming I don't get The Rash). Celexa worked OK @ 20mgs for a while, but I hate how SSRIs make me feel.
>
> Do you think I should just wait out the Lamictal increase (and the decrease in Abilify to 15) and see how I feel?
>
> I really should have talked to my doctor today. I just didn't know what to say, and my mood improved so much during our session. I also didn't want to make too many medication changes so soon. I mean, I'm no shrink, but couldn't Lamictal+an antidepressant=trouble, even on Abilify? Ugh. I just don't know. You'd think that an anti-*psychotic* would, you know...stop *psychosis*, wouldn't you?
>
>
> Maybe pills aren't even the answer. I'll be seeing a counselor in about a month. We'll see.
Posted by sigismund on August 17, 2011, at 13:48:28
In reply to silencing the voices in my head, posted by Christ_empowered on August 17, 2011, at 0:22:10
>I do seem crazy,
No, that's not crazy. That is very uncomfortable. It is not a particularly comfortable world.
Posted by floatingbridge on August 17, 2011, at 14:05:25
In reply to Re: silencing the voices in my head » Christ_empowered, posted by sigismund on August 17, 2011, at 13:48:28
> >I do seem crazy,
>
> No, that's not crazy. That is very uncomfortable. It is not a particularly comfortable world.sigi, I don't know how many times I get to agree with your posts w/o having bad boundaries....
I agree with what you wrote above.
Posted by Christ_empowered on August 17, 2011, at 16:34:46
In reply to Re: silencing the voices in my head » sigismund, posted by floatingbridge on August 17, 2011, at 14:05:25
It just seems so unfair. I get made fun of, confidential information about me gets tossed around town, and then I have to take meds. Really?!?!
But I do need something to help me be less of a tortured soul. Remeron?
Posted by floatingbridge on August 17, 2011, at 18:24:33
In reply to Re: silencing the voices in my head, posted by Christ_empowered on August 17, 2011, at 16:34:46
> It just seems so unfair. I get made fun of, confidential information about me gets tossed around town, and then I have to take meds. Really?!?!
>
> But I do need something to help me be less of a tortured soul. Remeron?It is unfair, not seems. I just went through the mill with some doctors myself. I behaved more civilly and sanely (as I was told by trusted close friends) than the world I was in. I said how come I'm the one on meds with more dx's than a prize-winning pig at a county fair has ribbons?
Could you call your doc again? I think relief is very reasonable. Personally, I don't know which medication.
Is agitation your primary target? Quieting the talk?
This sounds very stressful CE. Stress is an aggravating factor for anyone.....
Post if it helps at all. People here care.
Posted by floatingbridge on August 17, 2011, at 18:28:11
In reply to Re: silencing the voices in my head, posted by Christ_empowered on August 17, 2011, at 16:34:46
Do you have remeron in your med cabinet?
If so, have you responded to it o.k.?
I am not advocating self-medicating. Just want you feeling relatively o.k. and be safe.....
Posted by Christ_empowered on August 17, 2011, at 18:37:23
In reply to Re: silencing the voices in my head » Christ_empowered, posted by floatingbridge on August 17, 2011, at 18:28:11
I was just throwing Remeron out there. The SSRIs, the SNRIs, the TCAs..not so great. Reasonably effective, but at a price.
Odds are, if I call with something like this it'll be celexa, again. That's OK I guess.
Posted by floatingbridge on August 17, 2011, at 18:44:33
In reply to thanks, fb, posted by Christ_empowered on August 17, 2011, at 18:37:23
Celexa toned things down a bit for me as I recall. Good luck. Try and remeber it's temporary and will abate. Really. Just make yourself comfortable, then deal with real content later?
Posted by Phillipa on August 17, 2011, at 19:03:31
In reply to Re: silencing the voices in my head, posted by Christ_empowered on August 17, 2011, at 16:34:46
CE didn't you write that the combo of meds you were on was keeping the voices away? I'd seriously stick with them for now anyway. Phillipa
Posted by Christ_empowered on August 17, 2011, at 22:22:30
In reply to Re: silencing the voices in my head » Christ_empowered, posted by Phillipa on August 17, 2011, at 19:03:31
the intensity of the voices seems to wax and wane. Its better now than it has been in the past. I think I may still need an antidepressant, or maybe I can wait for the lamictal to get up to a higher dose. I'm not a threat to myself or others, so its not as if I'm a high needs patient at the moment...I just can't stand hearing these voices (which I realize come from my own mind).
Posted by sigismund on August 18, 2011, at 2:11:20
In reply to Re: silencing the voices in my head, posted by Christ_empowered on August 17, 2011, at 16:34:46
> Remeron?
You reckon? I mean, maybe, what do I know?
I'm useless with this. I spend so much time (not unlike you perhaps) having an anguished voice inside (or me saying it) 'I just want to die'.
Good luck with psychiatry helping you with this.
Posted by sigismund on August 18, 2011, at 2:19:53
In reply to the voices..., posted by Christ_empowered on August 17, 2011, at 22:22:30
When you say voices, I can only go from my own experience.
I know what it is like to have a head full of unruly thoughts, to walk around saying oh dear, and I just want to die. But those are feelings and thoughts; I wouldn't call them voices. And you don't call it OCD, like some intrusive thing (if that's what it is). So maybe your experience is different?
Posted by Christ_empowered on August 18, 2011, at 5:08:04
In reply to Re: the voices..., posted by sigismund on August 18, 2011, at 2:19:53
OK, maybe "voices" is a bad term. I think that since some of my other "issues" involve psychosis and the occasional experience of voices, that's the framework I'm working with.
A better description would be thoughts. Thoughts that I can hear, but thoughts nonetheless. Thoughts of certain people saying certain things, even having certain conversations. Thoughts about my past mixed as seen by (judging, condemning) others. The "others" are real people, but their conversations are imagined.
Posted by sigismund on August 18, 2011, at 15:23:37
In reply to Re: the voices..., posted by Christ_empowered on August 18, 2011, at 5:08:04
I suppose our minds reflect the world, and make it too, and therein lies the problem.
As I have got older my mind has become more fuzzy and blank. I can recall the conversations, wheels within wheels, when I was a kid out riding (a horse), and thinking then how vivid they were and how involved. Now I think the usual.....what a colossal waste......all that clarity expended on so much crap. Like you with that doctor who blabbed about you.
The only thing that is said to help with that which is not deadening is mindfulness meditation, isn't it?
Or filling up your mind with higher education type things maybe?
Posted by Phillipa on August 18, 2011, at 18:22:37
In reply to Re: the voices..., posted by Christ_empowered on August 18, 2011, at 5:08:04
CE to me that is a symptom of your illness and only my opinion I'd continue on the antipsychotic until they are silent and then maybe a taper? Just my view. Phillipa
Posted by Christ_empowered on August 18, 2011, at 18:30:29
In reply to Re: the voices... » Christ_empowered, posted by Phillipa on August 18, 2011, at 18:22:37
The "voices" get better when I have social interaction. I think sigi has a point--education, mindfulness, that sort of thing could help. And I will stay on the Abilify and hope that things start to clear up.
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