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Dr. Bob is Robert Hsiung, MD,
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Posted by 49er on August 9, 2009, at 16:44:20
In reply to Re: I took some depakote Scott » 49er, posted by SLS on August 8, 2009, at 9:51:20
> There are other perspectives regarding the rapid detoxification of benzodiazepines:
>
Scott,Are you being sarcastic about my caring about others?
Regarding your study, if I posted something like that that had just 10 people, you would greatly criticize me for the small study sample.
But more importantly, just because people are fine after 11 days doesn't mean they won't get hit with withdrawal symptoms 2 months later. That study would have more validity if people were followed for a year.
Here are patient reports of side effect which I admit doesn't make for a study. But remember, people weren't believed about ADs causing weight gain only for that to change later.
http://www.askapatient.com/viewrating.asp?drug=18723&name=DEPAKOTE
Here is a google search of depakote withdrawal:
49er
> **************************************************
>
> http://www.ncbi.nlm.nih.gov/pubmed/18821451?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
>
> Oxcarbazepine in rapid benzodiazepine detoxification.
> Croissant B, Grosshans M, Diehl A, Mann K.
>
> Department of Psychiatry, Psychotherapy and Psychosomatics, Teaching Hospital Sigmaringen, University of Tuebingen, Sigmaringen, Germany. [email protected]
>
> OBJECTIVE: This study aims at evaluating the tolerability and efficacy of the antiepileptic drug oxcarbazepine in benzodiazepine detoxification in ten patients. METHODS: In this case study of an inpatient withdrawal program, each of the ten patients was detoxified using oxcarbazepine and completed withdrawal successfully without the occurrence of withdrawal symptoms. The detoxification program followed an outlined dosage scheme with oxcarbazepine increase and benzodiazepine tapering. RESULTS: The rapidity of benzodiazepine detoxification using oxcarbazepine was remarkable, benzodiazepine withdrawal being completed in as little as 11 days. CONCLUSIONS: The results support the assumption that oxcarbazepine is a valuable drug for inpatient benzodiazepine withdrawal programs.
>
> **************************************************
>
>
> It is nice for you to care about others.
>
> What would happen if you were to learn that using Tegretol makes it possible to discontinue diazepam within a matter of weeks.
>
> I have been on Depakote several times at dosages that exceeded 1500mg. I never experienced any kind of withdrawal syndrome that required a slow taper. The rate of taper was that which was deemed prudent so as not to produce a seizure. Other than that, no problem. I had an equally uneventful discontinuation of Trileptal.
>
> Where did you find your stories regarding Depakote withdrawal?
>
>
> - Scott
Posted by SLS on August 9, 2009, at 18:48:30
In reply to Re: I took some depakote Scott, posted by 49er on August 9, 2009, at 16:44:20
> Are you being sarcastic about my caring about others?
Absolutely not.
- Scott
Posted by qbsbrown on August 9, 2009, at 19:20:08
In reply to Re: I took some depakote Scott » 49er, posted by SLS on August 9, 2009, at 18:48:30
Well, today is day 5 on 600mgs, 200-200-200, generic.
Some how, god only knows, I was able to go for a long car ride, get on a ferry boat, and spend a weekend around people at a cabin on a beautiful island.
That said. The new trend is this. I take the dose, and I get the bad depression/dysphoric feeling for about 4 hours, then it seems to wear off, and I have a bigger sense of normalcy day by day, less depression, more socialization, less paranoia. But by the time to take the next dose, I"m ready and need to.
It used to be that the med would only work for 4 hours then wear off.
Now this is the same weird physical depressive feeling i get in my head then if i were to take anything gaba related, even niacinimide.
In your opinion, is this the spike of the immediate releaase w/ the gaba giving my feeling of depression and dysphoria, then wearing off and feeling better? Even though it's wearing off after 4 hours, it's still affecting my brain, and in my blood correct?
Do you think that if I were to take the ER version, that I would either feel better, because I'm not getting a big spike, and peaks and valleys, or is there the possibility that the ER version could just be making me feel depressed much and much longer, because the gaba is being released longer?
I appreciate your help and ideas and any suggestions you can offer.
Kind regards,
Brian
Posted by qbsbrown on August 10, 2009, at 1:33:10
In reply to Scott, new trend. Your theory?, posted by qbsbrown on August 9, 2009, at 19:20:08
Well, we can go to 800mgs tomorrow like we talked about, after 5 days. Or do you think that I should wait 2 more days to make it an even week?
And I could go either 250-250-300, or 200-200-400. I'm thinking that the latter sounds better.
I guess i can stick w the generic. At least i know how i react, and that i can go out and do things.Last time I had bad dysphoria, i upped the dose, and it helped rid some.
My typing is still a little shaky, so still some wd and sxs adjusting to 600mgs.
But seriously, I don't care about dysphoria and/or depression, I just want off all of this crap. These psychotropic meds have ruined my life for the past 10 years, and I'd like to get it done with.
Most experts and benzo sites, would advocate decreasing by 1mg, every 1-4 weeks. I'm assuming that you would think other wise, and to try to get off quicker. Am I assuming correct?
Regards,
Brian
Posted by qbsbrown on August 10, 2009, at 1:50:16
In reply to Re: I took some depakote Scott, posted by 49er on August 8, 2009, at 9:20:58
I toally hear you 49er. I don't know you, and wasn't referring to you in any way, shape or form. I agree with almost all that you said. I don't like psych meds, and i want off all of them, and to resume my life. that's all.
I'm sorry if you took offense to something that I wrote, as it was not directed towards you, or anyone else on this board.
Best to health for all of us.
Regards,
Brian
Posted by SLS on August 10, 2009, at 6:53:49
In reply to Re: Scott, new trend. Your theory?, posted by qbsbrown on August 10, 2009, at 1:33:10
Although I try to stay away from theory and go with what works empirically, I am sure there are specific reasons for why you are experiencing these post-dose phenomena.
Tegretol potentiates GABA receptor stimulation and blocks sodium channels. With hyperexcitable glutamate neurons, you might get a combination of anxiety and dysphoria at the same time towards the end of the dosing period. Until the sodium channels become occupied again, the anxiety would persist during a time when increased GABA receptors occupancy produces the dysphoria. I am still mulling all of this over, so I am sure I've got it wrong.
Anyway, you can increase the dosage of Tegretol whenever you feel comfortable. It might prevent interdose loss of glutamate suppression and stop the rollercoaster ride.
I am glad that you are getting out more and functioning better.
- Scott
Posted by qbsbrown on August 10, 2009, at 9:41:43
In reply to Re: Scott, new trend. Your theory? » qbsbrown, posted by SLS on August 10, 2009, at 6:53:49
> Although I try to stay away from theory and go with what works empirically, I am sure there are specific reasons for why you are experiencing these post-dose phenomena.
>
> Tegretol potentiates GABA receptor stimulation and blocks sodium channels. With hyperexcitable glutamate neurons, you might get a combination of anxiety and dysphoria at the same time towards the end of the dosing period. Until the sodium channels become occupied again, the anxiety would persist during a time when increased GABA receptors occupancy produces the dysphoria. I am still mulling all of this over, so I am sure I've got it wrong.
>
> Anyway, you can increase the dosage of Tegretol whenever you feel comfortable. It might prevent interdose loss of glutamate suppression and stop the rollercoaster ride.
>
> I am glad that you are getting out more and functioning better.
>
>
> - ScottWell, it seems that the dysphoria has rubbed off for the most part. I think it was more of a situational thing. Where I haven't been in many social situations, because they have been too difficult to tolerate, and just the pressure stemming from it.
I think perhaps that 4 doses might be more prudent. Is it ok to dose at 6am-10am-2pm-10pm? Or is that last space too much? I might find that if I dose at 10, that I won't need the 2pm so early. I begin to do my strange obsessional/compulsive quirks around 10am, and it seems to alieviate it w/ in 30 mins, so i'd like to do it then
I'm sure that you are more for advocating the ER version, but it just seems to act so much differently, I don't know why.
Regards,
Brian
Posted by qbsbrown on August 10, 2009, at 9:44:52
In reply to Re: Scott, new trend. Your theory? » qbsbrown, posted by SLS on August 10, 2009, at 6:53:49
Do you think the ER version might prevent all of the interdose crap?
Brian
Posted by qbsbrown on August 10, 2009, at 12:43:30
In reply to Re: Scott, new trend. Your theory?, posted by qbsbrown on August 10, 2009, at 9:44:52
do I try to hold 800mgs for 1-2 weeks then begin tapering? Or just hold 1 week?
Brian
Posted by qbsbrown on August 10, 2009, at 15:31:45
In reply to Re: Scott, new trend. Your theory?, posted by qbsbrown on August 10, 2009, at 12:43:30
Wow, adding that 200mgs sure hit me. Started to sweat, typing woresened, anxiety, felt on the brink of a nervous breakdown. I hope that this all passes. I hope that I made the right choice with this med.
I know that it's expected to rev up my symptoms for a couple of days, just as it has in the past.Is dosing at 6-10-2-10 ok?
Brian
Posted by qbsbrown on August 10, 2009, at 16:57:40
In reply to Re: Scott, new trend. Your theory?, posted by qbsbrown on August 10, 2009, at 15:31:45
Do you think that 1000mgs is pushing the limit? It'd be nice to be able to dose every 4 hours til bedtime, so i don't get the interdose.
I guess we'll see how 800 plays out.
Brian
Posted by SLS on August 10, 2009, at 17:31:54
In reply to Re: Scott, new trend. Your theory?, posted by qbsbrown on August 10, 2009, at 15:31:45
> Wow, adding that 200mgs sure hit me. Started to sweat, typing woresened, anxiety, felt on the brink of a nervous breakdown. I hope that this all passes. I hope that I made the right choice with this med.
This is not what I was hoping to hear. You seem to report progress in that you are functioning better and going out more, etc. Then you report nearing a nervous breakdown. I cannot justify suggesting that you continue with this drug trial. The object was to make things better and not worse. I do not believe that 1000mg will serve you any better than 800mg. It sounds like you are experiencing withdrawal to me.
You might need to follow a taper schedule similar to what 49er recommended. He has his Babble-Mail enabled, so you can send a message directly to him. Tell him I said hello.
Discontinuing Tegretol might allow you to feel better as the blood level of diazepam will increase as a result.
- Scott
Posted by qbsbrown on August 10, 2009, at 17:53:13
In reply to Re: Scott, new trend. Your theory?, posted by SLS on August 10, 2009, at 17:31:54
> > Wow, adding that 200mgs sure hit me. Started to sweat, typing woresened, anxiety, felt on the brink of a nervous breakdown. I hope that this all passes. I hope that I made the right choice with this med.
>
> This is not what I was hoping to hear. You seem to report progress in that you are functioning better and going out more, etc. Then you report nearing a nervous breakdown. I cannot justify suggesting that you continue with this drug trial. The object was to make things better and not worse. I do not believe that 1000mg will serve you any better than 800mg. It sounds like you are experiencing withdrawal to me.
>
> You might need to follow a taper schedule similar to what 49er recommended. He has his Babble-Mail enabled, so you can send a message directly to him. Tell him I said hello.
>
> Discontinuing Tegretol might allow you to feel better as the blood level of diazepam will increase as a result.
>
>
> - ScottIt seemed to be an initial scary reaction (this has happened at other increased doses). Now settling in a bit. Much more comfy. W/o the tegretol, i can not leave the house. I can't afford to do or have that, there are things that I HAVE to be able to attend. If i were to discontinue, the flood gates of more racing thoughts would be worse, and i would return to being housebound.
I think that i'm in it for the long haul. If I do well at 800mgs for 5-7 days, then i think it might be good to continue to 1000mgs (because i could dose every 4 hours, perfect), then begin tapering.
Let me know what you think.
Regards,
Brian
Posted by qbsbrown on August 10, 2009, at 18:12:11
In reply to Re: Scott, new trend. Your theory?, posted by qbsbrown on August 10, 2009, at 17:53:13
My roommate has seen great improvements in me since adding it. Before, i wasn't able to leave the house, go for a ride, talk to people, i couldn't even talk to her when she came home, i was so stuck in my head and petrified. I went out to her cabin this week, and have been going for rides, and conversations every night.
This is just a spike in symptoms when i raise the dose, so we agreed that someone should be around when if i raise the dose again.
Sound good? Or do you think that I should still discontinue it?
Brian
Posted by SLS on August 11, 2009, at 5:08:35
In reply to Re: Scott, new trend. Your theory?, posted by qbsbrown on August 10, 2009, at 18:12:11
I think you should begin to taper the diazepam after being on 800mg of Tegretol for 5-7 days.
How much diazepam are you taking right now?
How did you plan to taper?
- Scott
Posted by qbsbrown on August 11, 2009, at 12:20:14
In reply to Re: Scott, new trend. Your theory?, posted by SLS on August 11, 2009, at 5:08:35
> I think you should begin to taper the diazepam after being on 800mg of Tegretol for 5-7 days.
>
> How much diazepam are you taking right now?
>
> How did you plan to taper?
>
>
> - ScottI am at 16mgs right now. I didn't know if I should continue at a Dr Ashton rate of 1mg every week or so, if speed it up if I can.
Crazy how my wd symptoms get much worse between doses. Especially typing. Fingers feel like they are in rigamortis style.
Probably best that i get the ER version huh? and go 200-200-400
Regards,
Brian
Posted by qbsbrown on August 11, 2009, at 14:27:46
In reply to Re: Scott, new trend. Your theory?, posted by qbsbrown on August 11, 2009, at 12:20:14
Do they work on anxiety? Being awake at 3am, i tried taking some unisom to sleep. It didn't work, but sure did take the edge off, made me feel drunk to where i wasn't giving a huge crap about everything. It even lowered my anxiety to where i was able to eat.
Are these ok to use? Or only for about 2 weeks or so?
Regards,
Brian
Posted by SLS on August 11, 2009, at 14:47:43
In reply to Antihistamines; is it just me or?, posted by qbsbrown on August 11, 2009, at 14:27:46
> Do they work on anxiety? Being awake at 3am, i tried taking some unisom to sleep. It didn't work, but sure did take the edge off, made me feel drunk to where i wasn't giving a huge crap about everything. It even lowered my anxiety to where i was able to eat.
That's interesting. I don't know what to suggest you do with this new information. Some antidepressants are very potent antihistamines. Doxepin is an old school favorite for doctors who used it to treat anxiety and insomnia.
At some point, you are going to need to be evaluated for any issues not yet resolved. Have you been diagnosed as having a mental illness? Have you ever been treated for one? Which drugs have you tried in the past, and what were the results?
- Scott
Posted by qbsbrown on August 11, 2009, at 16:39:34
In reply to Re: Antihistamines; is it just me or?, posted by SLS on August 11, 2009, at 14:47:43
> > Do they work on anxiety? Being awake at 3am, i tried taking some unisom to sleep. It didn't work, but sure did take the edge off, made me feel drunk to where i wasn't giving a huge crap about everything. It even lowered my anxiety to where i was able to eat.
>
> That's interesting. I don't know what to suggest you do with this new information. Some antidepressants are very potent antihistamines. Doxepin is an old school favorite for doctors who used it to treat anxiety and insomnia.
>
> At some point, you are going to need to be evaluated for any issues not yet resolved. Have you been diagnosed as having a mental illness? Have you ever been treated for one? Which drugs have you tried in the past, and what were the results?
>
>
> - ScottI have read about doxepin being used for benzos. Well one thouht that i was ocd, but that just stemmed from the benzo wd, and treated for bipolar 2 times, but it was only stemming from benzo usage as well. Oh we tried every med under the sun, all making me worse.
So the best option was to come off of all of them.
So my main and only problem is the benzos.
Posted by qbsbrown on August 11, 2009, at 16:52:41
In reply to Re: Antihistamines; is it just me or?, posted by qbsbrown on August 11, 2009, at 16:39:34
and i for sure would not return to a psychiatrist and those horrific meds. The goal is to be med free, and let my brain heal and return to it's homeostasis.
It's always been the benzos.
Brian
Posted by qbsbrown on August 11, 2009, at 18:32:50
In reply to Re: Antihistamines; is it just me or?, posted by qbsbrown on August 11, 2009, at 16:52:41
Do you think that doxepin would be worth a shot? Even Dr Ashton talks about it for anxiety and insomnia, both of which are terrible.
But all antidepressants other than lexpro make me more depressed ironically.
And how would TCA react w tegretol?
Lastly, is it ok to take benadryl during the day. And no, I'm not driving.
Regards,
Brian
Posted by qbsbrown on August 11, 2009, at 18:58:20
In reply to Re: Antihistamines; is it just me or?, posted by qbsbrown on August 11, 2009, at 18:32:50
I took benadryl 2 times during the day today, and it's by far the least anxiety that i've had in a long time. Something to that huh?
Posted by morganator on August 11, 2009, at 22:42:22
In reply to Re: Antihistamines; is it just me or?, posted by qbsbrown on August 11, 2009, at 18:58:20
> I took benadryl 2 times during the day today, and it's by far the least anxiety that i've had in a long time. Something to that huh?
Benadryl helps most people sleep better. Antihistamines can definitely help with anxiety. I have had 2 doctors prescribe an antihistamine for anxiety. I can't quite remember the name. It began with an X I think?
Posted by qbsbrown on August 11, 2009, at 22:55:29
In reply to Re: Antihistamines; is it just me or?, posted by morganator on August 11, 2009, at 22:42:22
> > I took benadryl 2 times during the day today, and it's by far the least anxiety that i've had in a long time. Something to that huh?
>
> Benadryl helps most people sleep better. Antihistamines can definitely help with anxiety. I have had 2 doctors prescribe an antihistamine for anxiety. I can't quite remember the name. It began with an X I think?Very interesting. I actually took Unisom, but is the same ingredient as Benadryl. I have both, perhaps will give the benadryl a go.
Just noticed that Seroquel is also a H1-receptor antagonists. Sometimes that med was fun (I'm now reading that it is being abused), but usually too much dysphoria during the day.
Let me know if you can think of the one that your doc recommended for anxiety. Thank you.
Are the antihistamines tolerance building (and dependence)? I hear that they can lose effectiveness over a couple of weeks.
I wonder if the doexipin is good for that. I worry a little about the serotonin in it though.
Brian
Posted by qbsbrown on August 12, 2009, at 12:01:17
In reply to Re: Antihistamines; is it just me or?, posted by qbsbrown on August 11, 2009, at 22:55:29
Scott;
Well yesterday was my best day by far. Had far less anxiety, especially w/ the antihistamine, was able to sleep, watch tv, and my sleep was better than ever.
That said, I still get some interdose problems between the 2pm and 10pm doses. I was dosing 6-10-2-10.
I think if I was able to go to 1000mgs, and keep the dosing at 4 hour intervals, and be able to dose at 6pm, that it might be very beneficial.
Your thoughts?
Brian
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Dr. Bob is Robert Hsiung, MD,
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