![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 163 to 187 of 212. Go back in thread:
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
Posted by qbsbrown on August 12, 2009, at 16:40:13
In reply to Re: Antihistamines; is it just me or?, posted by qbsbrown on August 12, 2009, at 12:01:17
I'm imagining the benefit was due to antihistamines being beneficial for anxiety, and also probably increased the cns depressant effects of diazepam, that the tegretol probably has. but anxiety was so bad, i couldn't eat, in fear of choking on food. The antihistamine sure removed that fear.
But I imagine that unisom or benadryl isn't a good idea long term. Someone mentioned Atarax, but that's only supposed to be used short term.
I'm pretty afraid of the deoxpin, although it might be the best choice. As I respond poorly to all ADs, and the whole serotonin/norepinephrine scare me.
Thanks for the thoughts/suggestions.
The ER just doesn't pack the same punch as the immediate release does. So it might be 200mgs 5x a day after 5 days. Park it there, then reduce diaz/
Posted by qbsbrown on August 12, 2009, at 21:09:36
In reply to Scott; Antihistamines, posted by qbsbrown on August 12, 2009, at 16:40:13
Doxepin and Tegretol don't play very nice together do they? Just checking out the drug interactions.
Brian
Posted by SLS on August 13, 2009, at 5:36:55
In reply to Re: Scott; Antihistamines, posted by qbsbrown on August 12, 2009, at 21:09:36
> Doxepin and Tegretol don't play very nice together do they? Just checking out the drug interactions.
What is the problem?
Where did you find this information? I'd like to take a look at it.
- Scott
Posted by qbsbrown on August 13, 2009, at 9:33:40
In reply to Re: Scott; Antihistamines, posted by SLS on August 13, 2009, at 5:36:55
I just did a search for drug interactions on different websites. Did speak to a pharmacist who said that the tegretol might lower the amount of doxepin.
Would that be like taking 2 tcas?
Would it be risking heart problems? I already had a small minor surgery for an arythmia.
I hate antidepressants, but it/they sure made tapering easier in the past.
I wonder if I could get a way with 25mgs at night.
Regards,
Brian
Posted by qbsbrown on August 13, 2009, at 10:58:44
In reply to Re: Scott; Antihistamines, posted by qbsbrown on August 13, 2009, at 9:33:40
Well, I wonder if adding doxepin might help. Another necisary evil w/ the tegretol. I have to eat, and i have to sleep. I'm waking up at 3am, and i wasn't able to eat before antihistamines.
The tegretol is already taking it normal anticonvulsant brain disabling mechanism in me. Not wanting to shower, to do dishes, the garbage,etc, the things i had finally returned to since quitting the meds. But I know this will be temporary.
Tomorrow, I go in to a detox facility for an assessment (it's required before taking my DUI classes (I drank 1 time in the last year, and got busted for a DUI), as they say coming off the benzos is dangerous, and they want the ok before being able to take their classes), so i'll let you know how that goes and what they say.
Brian
Posted by qbsbrown on August 13, 2009, at 11:40:05
In reply to Re: Scott; Antihistamines, posted by qbsbrown on August 13, 2009, at 10:58:44
Scott, I think I'm gonna take the tegretol to 1000mgs on saturday. That said, if I feel ready to cut a little bit, 1mg, should I go ahead? Or would you say wait til been on 1000mgs for 5 days?
Brian
Go forward in thread:
Psycho-Babble Withdrawal | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
[email protected]
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.