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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 23 to 47 of 47. Go back in thread:
Posted by Ritch on January 26, 2002, at 21:45:47
In reply to Re: Depakote/Neurontin/Amitrip » Ritch, posted by Chloe on January 26, 2002, at 18:30:46
>
>
>
> > You've had trouble before with lithium at doses that are going to be helpful. I found I have to get my dose up to about 450mg/day to really notice a difference-but for me those doses make me *really* foggyheaded and cause severe cramping and diarrhea.
>
> Mitch,
> You know what is funny, I really like the "foggyheaded" feeling. I feel really sensitive to noise and things around me. I prefer not being so *sharp*. I know that must sound strange. But I find the world very harsh, and I like how lithium tones things down, or reduces the volume for me...Is there any chance Depakote will do that at low doses? I don't remember feeling much cognitive "dulling" at all after adjusting to the stuff...But perhaps it has a different way of reducing the volume???Well, Chloe, all I can say is that you are lucky in some ways not to be bothered with this stuff. My job is so horrendously demanding-so left-brained-so draining. *Anything* that reduces my cognitive abilities-it shows straight away.
>
> > The Neurontin also seems to help you (I think you said it does?). So you could leave that one in-and you appear to tolerate it ok.
>
> There is something about neurontin that makes it so I can't stop it! Everytime I try to reduce the dose, I go crashing into an unmodivated, teary depression. And oh, my body aches, and I get horrible charlie horses in my arches and calves...I really do like N. But I think it adds to my skin troubles. And feel mixed about leaving it out, but I just can't!
> So, I would like to increase the dose a bit. I think it's useful for calming me, and not letting me get too enraged. But everytime I increase the dose, I get such dry skin and scalp pain. Go figure. So people take 3600 mgs of this stuff without a side effect! Not me!Neurontin was the first *anticonvulsant* I have tried that had a clear antidepressant effect-but I can't take more than about 400mg/day. Otherwise-I get blunting from it as well-esp. at doses above 600mg/day.
>
> > So, the tiny dose of amitrip. is definitely helping your neuropathic pain, right? It probably is working together with the Neurontin on that one. It does help you sleep better. I was taking nortrip. with my Celexa before (also nortrip. and Zoloft) and it worked fairly well. The NE boost *can* increase the likelihood for raging behavior. I popped off a little more often than otherwise-but I could focus a *lot* better at work and it didn't make me anxious.
>
> I know it's the ami that's making me "pop off." But I would describe it as I feel like my "blood is boiling." And the first person to look at me wrong is going to get hurt! Backing off to 10 mgs of ami has helped with the rages already...But my scalp is more "burny" with the lower dose. Also, I do wonder if it's causing my hair to fall out. I haven't even started the dep. and I seem to be shedding an awful lot. I thought I saw alot of scalp today, too...My hair is just not tolerating any of these meds well. My long thick hair is definitely no more. I just hope I can have moderate amount of hair, not desperately thin hair, where I am headed :(
>
> > So...the only thing left to try is the Depakote... I would suggest it. I have extra 125mg, 250mg, and 500mg tabs around just in case. I didn't notice any increased hairloss on it. I *did* gain some weight though. You could try adding just 125mg to your current mix (ditching the lithium) and see what happens. I have to take 125mg-250mg every so often when I get a mild mixed state and it really helps that.
>
> I have never heard of depakote prn...And you gained weight on lower doses of 500 or less? Was it related to increased appetite? God, I dread that. I hate the idea that medication can change the way I desire and consume food. Just doesn't seem fair...I do remember gaining weight when I was on 750 a few years ago. It was amazing. The weight just appeared. I never really felt any shift in eating or exercise...Well, Depakote prn is what I *do*. I can take 250mg if I am feeling unusally agitated or panicky and it augments the Neurontin/Klonopin I am taking and makes things a lot easier.
>
> > Yes, I am starting to have an increased level of agitation and may need to start taking some Dep. a little bit here myself. That goes away by the end of March and then I just deal with plain-old bubbly hypomania during April, March, and part of June-which I don't mind :)
>
> Boy, I love how predictable your cycling is. At least you have some idea as to when all hell is going to break loose! But I am sure it doesn't make you suffering any less.
>
> Many thanks, Mitch
> Chloe
Predictability *is* nice-but you have to get your pdoc tuned in to the graph! They have this tendency to think that your "troubles" are the same all year round(static). I think I am going to have to do a Powerpoint presentation and bring in all the hardware, etc. I don't really think they *want* to be lazy, but for what I am paying.......Mitch
Posted by Chloe on January 27, 2002, at 17:50:28
In reply to Re: Depakote/Neurontin/Amitrip » Chloe, posted by Ritch on January 26, 2002, at 21:45:47
Mitch,
Do you think that amitrip in itself, being a "dirty" drug, could be contributing to my rages? Or do you think all the TCA's are pretty much the same?
I like the sedating effect of Ami (at last I sleep at night!!!), but I do think it causes my heart to race at time during the day...And I get so damn furious and hostile, I can't think straight.
Of course I haven't had time for the depokote to work yet...
But is there another "calming" or sedating TCA that might work better than Ami for neuropathic pain (and sleeping at night, too!)?
I have heard that Doxepin has some antihistimine in it. Is it the same kind like in Remeron or Zyprexa? I hate the appetite increase thing. I know I wouldn't like Doxe if it's similar to them..
Any thoughts?Best,
Chloe
Posted by Ritch on January 27, 2002, at 22:05:04
In reply to Re:TCA less likely to cause rage?, posted by Chloe on January 27, 2002, at 17:50:28
> Mitch,
> Do you think that amitrip in itself, being a "dirty" drug, could be contributing to my rages? Or do you think all the TCA's are pretty much the same?
> I like the sedating effect of Ami (at last I sleep at night!!!), but I do think it causes my heart to race at time during the day...And I get so damn furious and hostile, I can't think straight.
> Of course I haven't had time for the depokote to work yet...
> But is there another "calming" or sedating TCA that might work better than Ami for neuropathic pain (and sleeping at night, too!)?
> I have heard that Doxepin has some antihistimine in it. Is it the same kind like in Remeron or Zyprexa? I hate the appetite increase thing. I know I wouldn't like Doxe if it's similar to them..
> Any thoughts?
>
> Best,
> ChloeChloe, I have tried most of the TCA's for several weeks and some cases several years. Doxepin was the first antidepressant I took and I had the dose up to 150mg/day for a while (with lithium). All of the TCA's have antihistaminic effects more or less-one could say they are antihistamines that happen to have antidepressant properties. Doxepin even at 75mg/day gave me tachycardia. For some weird reason it was the worst when I first woke up in the morning. I would be dreaming and then I would startle and wake and my heart would race up to 150+bpm for a few minutes.
I had more *rages* while on high-dose doxepin (doxepin has an anti-serotonin effect) than low-dose amitriptyline (no remarkable rage incidents there). All TCA's are *dirty* to some extent-that is if you look at them as several drugs in one-they can be helpful for irritable bowel(anticholinergic action), insomnia(sedative-antihistaminegic action), neuropathic pain (NE-opioid potentiation?).
Notriptyline was the easiest one for me to tolerate (the active metabolite of amitripytline). I didn't get any dizziness and vertigo on it like the others, and dry mouth wasn't as bad. Also, FWIW, I didn't experience any noticeable appetite increase with it either( unlike Remeron or Seroquel). Desipramine did aggravate temper and caused some hypomania, though. Maybe if you could switch the amitriptyline to nortriptyline and still get the analgesic effect you need with fewer side effects??? Ask your doc. I found low-dose Celexa + low-dose Nortriptyline to work quite well.
BTW, Older antipsychotics like chlorpromazine are structurally quite similar to the first TCA's. Older AP's and even the newer ones like Zyprexa have a fairly powerful antihistaminic effect. Nortrip. has a much lowered antihistaminic effect, but it doesn't increase extracellular serotonin very much-although it *does* downregulate serotonin receptors (which is probably helpful for panic sufferers).
Mitch
Posted by Chloe on January 28, 2002, at 9:42:05
In reply to Re:TCA less likely to cause rage? » Chloe, posted by Ritch on January 27, 2002, at 22:05:04
Thanks Mitch,
This is useful. I tried to talk to my pdoc about this, and she hadn't heard of any TCA causing rages, per say, that I was just probably in a mixed state from too much AD. Hence she told me to lower the Celexa. NOT a good idea.So I am the one who has to choose the meds. She doesn't want to make a switch at all. So I really have to make a case and advocate for myself. I thought doxepin was a good one try next since it's used often in neuropathic pain. And from what I read at google, is supposes to have less cardiac issues than ami. But clearly, that is not your experience! And is sedating, so I will sleep through the night.
I did not think Nort. would be useful because it can be activating. And that just seems to make my temper worse...But I just don't know. I am so lost here, and feel so stranded, trying to pick out meds for myself. I wish I could hook up with a pdoc who had some experience with this. But my last pharm consult was expensive and not useful. So I guess for now I have to try to figure this out on my own. I wish I had heard from you before I called her about doxepin. But it's already done. It's all trial and error anyway. And I don't plan to take more than 20 mgs of any these TCA's. And it may turn out that I can't tolerate any of them. I just have to be so careful. I keep blowing up and saying really mean things and just feeling nasty and grumpy...
I am really scared. I have to try and be in better control of my anger today. This is NOT ususally something I have to work at...
BTW, did nortrip help you sleep better?
Thanks again
Chloe
Posted by Ritch on January 28, 2002, at 10:41:21
In reply to Re:TCA less likely to cause rage? » Ritch, posted by Chloe on January 28, 2002, at 9:42:05
> Thanks Mitch,
> This is useful. I tried to talk to my pdoc about this, and she hadn't heard of any TCA causing rages, per say, that I was just probably in a mixed state from too much AD. Hence she told me to lower the Celexa. NOT a good idea.
She might be correct about that-given that your levels of mood stabilizer(s) are quite low. I am starting to have a problem with "mixed" symptomology. I have backed off the Wellbutrin to just 1/4 of a 75mg tablet with my 2.5 mg of Celexa 4-5x a week (I skip days here and there because of the heartburn). I go to sleep, but it is very light and unrestful, and I just tend to lay around in bed half-awake for a long time. Then I am half-awake all day long it seems. The WB is starting to make my skin itch (pruritis) and for some odd reason the bottoms of my feet are *sweating*. (whatever!)
I am going to bug my pdoc about going back on a pstim (swap out the WB). With the other meds I think it will work out better. Christ, I started checking my BP the last few days (when I was taking nearly 75mg of WB every day) and it had consistently gone up from around 120/75 to nearly 150/95! I didn't have an increase like that with Adderall and it worked better.
>
> So I am the one who has to choose the meds. She doesn't want to make a switch at all. So I really have to make a case and advocate for myself. I thought doxepin was a good one try next since it's used often in neuropathic pain. And from what I read at google, is supposes to have less cardiac issues than ami. But clearly, that is not your experience! And is sedating, so I will sleep through the night.
>
> I did not think Nort. would be useful because it can be activating. And that just seems to make my temper worse...But I just don't know. I am so lost here, and feel so stranded, trying to pick out meds for myself. I wish I could hook up with a pdoc who had some experience with this. But my last pharm consult was expensive and not useful. So I guess for now I have to try to figure this out on my own. I wish I had heard from you before I called her about doxepin. But it's already done. It's all trial and error anyway. And I don't plan to take more than 20 mgs of any these TCA's. And it may turn out that I can't tolerate any of them. I just have to be so careful. I keep blowing up and saying really mean things and just feeling nasty and grumpy...
>
> I am really scared. I have to try and be in better control of my anger today. This is NOT ususally something I have to work at...
> BTW, did nortrip help you sleep better?
> Thanks again
> Chloe
Perhaps *I* shouldn't have knocked doxepin so much! YMMV. Nortrip. produces a "light" sedative effect at best-it was the only TCA I could stand to take during the day. You are correct-it might be too activating. What the heck-give the doxepin a shot (just 10mg at bedtime). You WILL really sleep good on that one. My brother is taking it now for arthritis with other meds. I just tend to get grouchy on sedative meds, that's all.Let me know how the doxepin goes, OK?
Mitch
Posted by Chloe on January 28, 2002, at 19:48:33
In reply to Re:TCA less likely to cause rage? » Chloe, posted by Ritch on January 28, 2002, at 10:41:21
Thanks for getting back to me so fast...
So far reply from the pdoc. My suspicion is that she just thinks I am in a mixed agitated state. And that with time and depakote, I will forget about how amitriptyline is making me more enraged! I am not sure she was buying that it was "the amitriptyline."
Or she is just really busy, that's a possiblity too, I suppose...I will let you know what happens. I really appreciate your thoughtful, informative posts, esp when I feel so edgy and stranded! I am sorry about your WB problems. Sounds like it maybe time to make a switch to a tad of adderall. Will your pdoc go for it? I hope you can get some relief soon. Maybe you could try 100%cotton (absorbent!) socks for your feet?
Chloe
Posted by Chloe on January 28, 2002, at 20:45:54
In reply to Re:TCA less likely to cause rage? » Chloe, posted by Ritch on January 28, 2002, at 10:41:21
I got some crazy ambiguous email from my pdoc saying that she doesn't know which TCA is better than another for neuropathic pain (completely missing the part about how I think ami, in particular, is causing my increased cycling and rages). And that she is sorry that things "aren't much better."
She never even mentioned the doxepin 10 mgs capsules I specifically asked for. Did she even read the damn detailed email I sent her, with excerpt? I am living in bazarro world...I have a mind to torpedo a scathing email back. But I think I better wait until the morning and see if I should actually send it. Damn, I am so tired of this crap. I spent all this time researching doxepin, TCAs, Ami and increase cycling. And she just ignored it. What the hell?
Sorry for the rant.
Chloe
Posted by Ritch on January 28, 2002, at 23:12:07
In reply to Re:TCA less likely to cause rage? » Ritch, posted by Chloe on January 28, 2002, at 19:48:33
> Thanks for getting back to me so fast...
>
> So far reply from the pdoc. My suspicion is that she just thinks I am in a mixed agitated state. And that with time and depakote, I will forget about how amitriptyline is making me more enraged! I am not sure she was buying that it was "the amitriptyline."
> Or she is just really busy, that's a possiblity too, I suppose...
>
> I will let you know what happens. I really appreciate your thoughtful, informative posts, esp when I feel so edgy and stranded! I am sorry about your WB problems. Sounds like it maybe time to make a switch to a tad of adderall. Will your pdoc go for it? I hope you can get some relief soon. Maybe you could try 100%cotton (absorbent!) socks for your feet?
>
> Chloe
Well..I already wear absorbent 100% cotton socks. Our company president is "casual Friday" all week long. I already noticed less itching and sweating today by reducing the WB. I don't really need it that much right now anyhow. The thing that dissapoints me about it is that it doesn't seem to help my attentiveness as much as pstims or even nortripytline helped. It seems to just eliminate melancholia and keeps me awake-that's about it. I would like to get rid of it and try a different low-dose pstim (than Adderall). I am interested in trying either Provigil or Focalin. The Focalin sounds interesting because we never tried methylphenidate before, just amphetamines. Also, the Focalin appears to be easier on your liver, etc. than the Provigil.Oh, as far as your thoughts/questions about the difference between doxepin and amitripytline.... Don't get too worried about it..really. Just take 10mg of the amitrip. at bedtime for sleep (if that's what your pdoc wants you to do anyhow). If it is helping you sleep and reducing pain-hey-maybe just waiting for the right mood stabilizer(s) to work could be the right plan.
Mitch
Posted by Chloe on January 30, 2002, at 9:09:25
In reply to Re:TCA less likely to cause rage? » Chloe, posted by Ritch on January 28, 2002, at 23:12:07
> Well..I already wear absorbent 100% cotton socks. Our company president is "casual Friday" all week long. I already noticed less itching and sweating today by reducing the WB. I don't really need it that much right now anyhow. The thing that dissapoints me about it is that it doesn't seem to help my attentiveness as much as pstims or even nortripytline helped. It seems to just eliminate melancholia and keeps me awake-that's about it. I would like to get rid of it and try a different low-dose pstim (than Adderall). I am interested in trying either Provigil or Focalin. The Focalin sounds interesting because we never tried methylphenidate before, just amphetamines. Also, the Focalin appears to be easier on your liver, etc. than the Provigil.I thought methylphenidate was an amphetimine. I took Ritalin in my "golden days" when I was on Mellaril. Ritalin is very effective for improving mood and concentration. But the crashes, even with the ER formula were almost unbearable. I have read a little about focalin. It's supposed to be gentler...Too bad your pdoc is not a fan of Provigil. But, in all fairness to him, it is still quite new. I hope you find something better than what you have now. Sounds like less WB is helping a little.
> Oh, as far as your thoughts/questions about the difference between doxepin and amitripytline.... Don't get too worried about it..really. Just take 10mg of the amitrip. at bedtime for sleep (if that's what your pdoc wants you to do anyhow). If it is helping you sleep and reducing pain-hey-maybe just waiting for the right mood stabilizer(s) to work could be the right plan.Thanks for your levelheadedness! I got so enraged at my pdoc for not even answering the question I put out to her. I have since learned that she just doesn't know anything about TCA's causing rages in particalar...Whatever. Pdoc's are so behind the times. So frustrating...
I think the depakote is helping, though. I have had a day without a unrelenting rage outburst. But I since starting dep, 125mg at bedtime, my sleep is totally disrupted. It's like I went back to per-amitriptyline sleep. I though Dep. was supposed to help sleep! Do you have any thoughts on this? Should I take it in the am? I think I will try to start a thread about Dep and sleep disturbance...Got to rush off now though.Take care
Chloe
>
> Mitch
Posted by Ritch on January 30, 2002, at 9:37:37
In reply to Re:TCA/focalin/depakote/sleep? » Ritch, posted by Chloe on January 30, 2002, at 9:09:25
>
> > Well..I already wear absorbent 100% cotton socks. Our company president is "casual Friday" all week long. I already noticed less itching and sweating today by reducing the WB. I don't really need it that much right now anyhow. The thing that dissapoints me about it is that it doesn't seem to help my attentiveness as much as pstims or even nortripytline helped. It seems to just eliminate melancholia and keeps me awake-that's about it. I would like to get rid of it and try a different low-dose pstim (than Adderall). I am interested in trying either Provigil or Focalin. The Focalin sounds interesting because we never tried methylphenidate before, just amphetamines. Also, the Focalin appears to be easier on your liver, etc. than the Provigil.
>
> I thought methylphenidate was an amphetimine. I took Ritalin in my "golden days" when I was on Mellaril. Ritalin is very effective for improving mood and concentration. But the crashes, even with the ER formula were almost unbearable. I have read a little about focalin. It's supposed to be gentler...Too bad your pdoc is not a fan of Provigil. But, in all fairness to him, it is still quite new. I hope you find something better than what you have now. Sounds like less WB is helping a little.Actually, I have *transitioned* out of the melancholic winter SAD episode entirely this week and probably will taper what little WB I am taking away by next week. The attentional probs I have obviously get quite bad during the major depressions. When those clear my focus is adequate enough probably without a pstim. That would leave me on Neurontin, Klonopin, and Celexa. That's cool.
As far as pstim "crashes" go I didn't have any problem on Adderall. I took one 5mg tab in the morning as soon as I got up and felt fine all day. I noticed a little fatigue about an hour or two before I went to sleep. I remember when I took just 2.5mg in the am, I *did* crash in the evenings at work and got kind of grouchy. I don't have any probs with taking small doses up to 3x daily (I already take Neurontin 3x daily).
>
> > Oh, as far as your thoughts/questions about the difference between doxepin and amitripytline.... Don't get too worried about it..really. Just take 10mg of the amitrip. at bedtime for sleep (if that's what your pdoc wants you to do anyhow). If it is helping you sleep and reducing pain-hey-maybe just waiting for the right mood stabilizer(s) to work could be the right plan.
>
> Thanks for your levelheadedness! I got so enraged at my pdoc for not even answering the question I put out to her. I have since learned that she just doesn't know anything about TCA's causing rages in particalar...Whatever. Pdoc's are so behind the times. So frustrating...
> I think the depakote is helping, though. I have had a day without a unrelenting rage outburst. But I since starting dep, 125mg at bedtime, my sleep is totally disrupted. It's like I went back to per-amitriptyline sleep. I though Dep. was supposed to help sleep! Do you have any thoughts on this? Should I take it in the am? I think I will try to start a thread about Dep and sleep disturbance...Got to rush off now though.
>
> Take care
> Chloe
> >
> > Mitch
Yes, I doubt if you are going to find many agents as capable of producing sleep as amitriypline. You might chop one of those 10mg tabs in half and just take 5mg at bedtime-use it as your sleeper. Depakote *helps* with sleep, but it won't guarantee it.Mitch
Posted by Chloe on January 30, 2002, at 9:55:31
In reply to Re:TCA/focalin/depakote/sleep?, posted by Ritch on January 30, 2002, at 9:37:37
> Yes, I doubt if you are going to find many agents as capable of producing sleep as amitriypline. You might chop one of those 10mg tabs in half and just take 5mg at bedtime-use it as your sleeper. Depakote *helps* with sleep, but it won't guarantee it.
Mitch,
I am still taking the 10 mgs of Ami+125 depakote at bedtime. But since adding the dep, my sleep is very light, and I have several wakings in the night/early am. Like it was before I started ami. BUT I am still on the ami. Do you know if I will adjust to the dep and start sleeping through the night again? That was heaven...Chloe
Posted by Elizabeth on January 30, 2002, at 13:21:41
In reply to Re: TCA's and BPD-Link? » Elizabeth, posted by Chloe on January 25, 2002, at 17:15:47
Hi Chloe. No, I don't know of a web site where you could read about BPD (or rapid cycling) and tricyclics. It's something I've read in several places, though.
> After two weeks on amitriptyline, I am having increased cycling and horrific aggitated mixed states.
20 mg is a small amount in normal metabolizers, so the worsening might have nothing to do with the amitriptyline. You might want to see a neurologist about the pain, though.
> I have not lost my temper in such abrupt and abusive ways in so long. I am sure it's the amitrip. and asked my pdoc to switch to doxepin. She refused. Saying that all TCA;s are alike. Changing won't make a difference.
That's not really true, although I'm not sure that doxepin would be better than amitriptyline. (Doxepin is generally more sedating, but otherwise there isn't really much predictable difference.)
> Anyway, I was hoping you had a link that I could give to her that says Ami is "particularly" bad for the rapid cycling bipolar (ex-BPD, since I have not been self destructive in over a decade..), like me.
Self-destructiveness is just one symptom of BPD, and rapid-cycling bipolar disorder like you describe is pretty much indistinguishable from BPD. But anyway, no, I don't know of any web sites. Have you tried doing searches? Searching Medline would definitely turn up some results (although bear in mind that this hasn't been studied extensively so you're not going to get any rigorous clinical trials).
> If I just didn't have this dumb scalp pain induced from the lithium, I could just go up on that and I think the cycling would decrease. But without a TCA, the burning is so painful, I can't tolerate the Li...
Do you think the lithium is helping? It sounds like that may be more of a problem than a help!
-elizabeth
Posted by Elizabeth on January 30, 2002, at 13:28:00
In reply to Re:TCA less likely to cause rage?, posted by Chloe on January 27, 2002, at 17:50:28
Chloe,
Most of the TCAs are antihistamines; doxepin is the strongest, and amitriptyline is the second-strongest. I don't think that an antihistamine will help with your rages, though.
-e
Posted by Ritch on January 30, 2002, at 13:30:40
In reply to Re:TCA/depakote/sleep? » Ritch, posted by Chloe on January 30, 2002, at 9:55:31
> > Yes, I doubt if you are going to find many agents as capable of producing sleep as amitriypline. You might chop one of those 10mg tabs in half and just take 5mg at bedtime-use it as your sleeper. Depakote *helps* with sleep, but it won't guarantee it.
>
> Mitch,
> I am still taking the 10 mgs of Ami+125 depakote at bedtime. But since adding the dep, my sleep is very light, and I have several wakings in the night/early am. Like it was before I started ami. BUT I am still on the ami. Do you know if I will adjust to the dep and start sleeping through the night again? That was heaven...
>
> Chloe
Chloe,It is possible that the AD effect of the amitrip. is starting to "kick in" and/or you are starting to become tolerant to the antihistamine-induced drowsiness. How long have you been taking the amitrip.? TCA's are weird-they have this 2-3week waiting period before they kick-in. SSRi's can "kick-in" right away up to less than 10 days with me.
Oh yeah! I just remembered, when I started taking Depakote my pdoc wanted me to take it about four hours before bedtime in the evening. It takes a little while to peak. That way the "peak" hits right about bedtime. Also, it will accumulate for a while and it may take a week or so before you see the sleep benefit-I definitely did have sleep benefits from it.
Mitch
Posted by Chloe on January 31, 2002, at 18:12:31
In reply to Re:TCA less likely to cause rage?, posted by Elizabeth on January 30, 2002, at 13:28:00
Elizabeth,
My pdoc didn't think a switch would make any difference either. She just thought I was having a mixed, agitated state from too much AD (1.5 mgs Celexa and 10 mgs of amitriptyline!). I was so enraged and so sure she was wrong !
Turns out she was right. Adding Depakote to my neurontin has smoothed things out pretty well. I am humble again :)Thanks for your reply
Chloe
>
> Most of the TCAs are antihistamines; doxepin is the strongest, and amitriptyline is the second-strongest. I don't think that an antihistamine will help with your rages, though.
>
> -e
Posted by Chloe on January 31, 2002, at 18:26:06
In reply to Re:TCA/depakote/sleep?, posted by Ritch on January 30, 2002, at 13:30:40
> It is possible that the AD effect of the amitrip. is starting to "kick in" and/or you are starting to become tolerant to the antihistamine-induced drowsiness. How long have you been taking the amitrip.? TCA's are weird-they have this 2-3week waiting period before they kick-in. SSRi's can "kick-in" right away up to less than 10 days with me.
Mitch,
I have been taking ami about a month. My rages started about the 2 week mark, now that I look back...The antianxiety effect seemed to wear off around the two week mark too. I miss that calming feeling. But the depakote is starting to smooth things out. But I don't feel dep has much anti-anxiety effect, so far. Perhaps I am not taking enough. I am supposed to go up to 250 tomorrow...Just so scared I am going to blow up like a ballon...Does everyone gain weight on Dep? and on lower doses?...From the posts I have read, dep is starting to sound like Zyprexa. But I don't have the ravenous appetite like I did with that one.
> Oh yeah! I just remembered, when I started taking Depakote my pdoc wanted me to take it about four hours before bedtime in the evening. It takes a little while to peak. That way the "peak" hits right about bedtime. Also, it will accumulate for a while and it may take a week or so before you see the sleep benefit-I definitely did have sleep benefits from it.This was useful. I took it about 6 last night and started to feel slightly drowsy around 9. So your doc was right. And I did sleep a little better last night, thanks. But still suffered from some early morning waking issues...I can hope for the seamless sleep again where I don't wake up for 8 hours. That is priceless in my book.
Hope you are doing ok. Thanks again
Chloe
Posted by Ritch on February 1, 2002, at 0:45:23
In reply to Re:TCA/depakote/sleep? » Ritch, posted by Chloe on January 31, 2002, at 18:26:06
> Mitch,
> I have been taking ami about a month. My rages started about the 2 week mark, now that I look back...The antianxiety effect seemed to wear off around the two week mark too. I miss that calming feeling. But the depakote is starting to smooth things out. But I don't feel dep has much anti-anxiety effect, so far. Perhaps I am not taking enough. I am supposed to go up to 250 tomorrow...Just so scared I am going to blow up like a ballon...Does everyone gain weight on Dep? and on lower doses?...From the posts I have read, dep is starting to sound like Zyprexa. But I don't have the ravenous appetite like I did with that one.
>
> > Oh yeah! I just remembered, when I started taking Depakote my pdoc wanted me to take it about four hours before bedtime in the evening. It takes a little while to peak. That way the "peak" hits right about bedtime. Also, it will accumulate for a while and it may take a week or so before you see the sleep benefit-I definitely did have sleep benefits from it.
>
> This was useful. I took it about 6 last night and started to feel slightly drowsy around 9. So your doc was right. And I did sleep a little better last night, thanks. But still suffered from some early morning waking issues...I can hope for the seamless sleep again where I don't wake up for 8 hours. That is priceless in my book.
> Hope you are doing ok. Thanks again
> Chloe
Hi Chloe,Glad to hear you are feeling "smoothed out". I can even tell it in your writing. You said that you are going up to 250mg tomorrow? You still are taking it all in the evening? Just a bit of advice-but I would take all of it in the evening if you are having some probs with early morning awakening. Yeah, I gained weight even on the lower doses-BUT *not* having the munchies is a good sign. I *did* have the munchies when I was on lower doses, so maybe you won't have that much of a problem. Are you still on the amitripytline? Are you taking the Depakote in addition to your Neurontin? The Depakote has a long enough half-life so that you *might* be able to take your Neurontin twice a day instead of 3-4x daily (So you could toss in more Neurontin right before you go to bed-and that might help your sleep also).
There is one thing I have been trying lately for sleep soundness and it is adding a tiny dose of Melatonin (200 micrograms) at bedtime, and it seems to be helping. Another thing I really want to investigate is Omega3 stuff. I tried the "fish oil" gelcaps-YUCK-I have heartburn and it was pretty nasty. I heard that flaxseed oil has high Omega3 fatty acids and isn't "fishy". The reason I bring that thing up is I have heard it helps kids with ADHD as well as bipolar.
Mitch
Posted by Chloe on February 1, 2002, at 19:03:43
In reply to Re:TCA/depakote/sleep? » Chloe, posted by Ritch on February 1, 2002, at 0:45:23
>
> Glad to hear you are feeling "smoothed out". I can even tell it in your writing. You said that you are going up to 250mg tomorrow? You still are taking it all in the evening? Just a bit of advice-but I would take all of it in the evening if you are having some probs with early morning awakening. Yeah, I gained weight even on the lower doses-BUT *not* having the munchies is a good sign. I *did* have the munchies when I was on lower doses, so maybe you won't have that much of a problem. Are you still on the amitripytline? Are you taking the Depakote in addition to your Neurontin? The Depakote has a long enough half-life so that you *might* be able to take your Neurontin twice a day instead of 3-4x daily (So you could toss in more Neurontin right before you go to bed-and that might help your sleep also).Hi Mitch,
I don't know if I should take the other 125 mgs in the am or pm. I don't find it helps me sleep, yet anyway. So I was wondering if I should spread the dose evenly thoughout the day. I have read it has a 5-20 hour half life. Now that is a big range...I probably should have tried it this am, and seen how I tolerated it during the day. But I didn't. And tomorrow I have to work, retail, so I don't want to be "too" out of it. You think one evening dose is best for sleep reasons? But what about for cycling coverage? Have you ever taken it BID?I am still taking the neurontin, 100mgs am, 100mgs 4-5pm, 200 hs. I wish I could take it BID...But I start to sweat and get the shakes if I go much longer than 7 hours without a dose. I always thought it was low blood sugar...But food doesn't cure the neurontin shakes and sweats!
I am still taking the amitriptyline. Though, now it seems like a sugar pill. My sleep is still very light. But I think it's important to keep it on board. I have probably built up a tolerance to the sedating effects. But, it has elevated my energy level, and desire to "do" more. I still get this swell of rage inside a few times a day, but it's not overwhelming. I might fuss or complain for a while. But the rages/agitation that were lasting 30 hours have subsided for now. I have had two days without a huge disruption. Whahoo!
> There is one thing I have been trying lately for sleep soundness and it is adding a tiny dose of Melatonin (200 micrograms) at bedtime, and it seems to be helping. Another thing I really want to investigate is Omega3 stuff. I tried the "fish oil" gelcaps-YUCK-I have heartburn and it was pretty nasty. I heard that flaxseed oil has high Omega3 fatty acids and isn't "fishy". The reason I bring that thing up is I have heard it helps kids with ADHD as well as bipolar.I have used melatonin before. I am a bit leery of it though, since it can be depressogenic. And it's not known to help with early morning wakening, etc. But if I need to shut down the brain so I can fall asleep, I think it's a good remedy as needed. I might have to go digging in the medicine cabinet and haul that one out for a try...
In terms of fish oil, I take 2 grams(capsules) every night *right* before bed. I do not want them to start digesting until I am asleep. Burping fish oil is one of the most unpleasant experiences there is! I never take them during waking moments! I have no idea if they do anything for mood stabilization, etc. But I have heard that they are good for people with skin problems, ezcema and the like, which is me! It's been part of my routine for years now...So I guess it's not much help for the URC! I too want to try some flax seed oil. It does seem more benign than the fish oil. Though I really don't notices it anymore, since I take it right before bed.
Are you completely off the WB now?
Thanks
Chloe
Posted by Ritch on February 1, 2002, at 22:22:06
In reply to Re:TCA/depakote/sleep? » Ritch, posted by Chloe on February 1, 2002, at 19:03:43
> Hi Mitch,
> I don't know if I should take the other 125 mgs in the am or pm. I don't find it helps me sleep, yet anyway. So I was wondering if I should spread the dose evenly thoughout the day. I have read it has a 5-20 hour half life. Now that is a big range...I probably should have tried it this am, and seen how I tolerated it during the day. But I didn't. And tomorrow I have to work, retail, so I don't want to be "too" out of it. You think one evening dose is best for sleep reasons? But what about for cycling coverage? Have you ever taken it BID?
Hi Chloe,I think the 5-20hr half-life includes folks that are taking older antiepileptic meds (or other meds) that induce (accelerate) metabolism of the Depakote and are eliminating it faster than they would otherwise. What I understand it to be typically is about 14-18 hrs. The dosing recommendations I have seen is all in the evening or at bedtime until the dose gets bumped above 500mg/day-you don't want to take more than 500mg as a single dose. I have taken 125mg once daily, 125mg twice daily, 250mg once daily, 250mg twice daily, and 500mg once daily. Just a suggestion-but I would split the 250mg/day into two doses of 125mg each. You might consider taking one tablet *after* your evening dinner, and then take one right before you go to bed with your Neurontin/Amitrip. and see how that goes. Daytime dosing went ok with me, I just wanted to avoid taking it earlier in the day because I would get the munchies later and eat too much.
>
> I am still taking the neurontin, 100mgs am, 100mgs 4-5pm, 200 hs. I wish I could take it BID...But I start to sweat and get the shakes if I go much longer than 7 hours without a dose. I always thought it was low blood sugar...But food doesn't cure the neurontin shakes and sweats!Well, it sounds like you have a healthy pair of kidneys! You probably ought to stick with the same Neurontin dosing schedule then.
>
> I am still taking the amitriptyline. Though, now it seems like a sugar pill. My sleep is still very light. But I think it's important to keep it on board. I have probably built up a tolerance to the sedating effects. But, it has elevated my energy level, and desire to "do" more. I still get this swell of rage inside a few times a day, but it's not overwhelming. I might fuss or complain for a while. But the rages/agitation that were lasting 30 hours have subsided for now. I have had two days without a huge disruption. Whahoo!
Sounds like the Depakote has put a damper on it for sure. Also, I found amitriptyline to be the least likely TCA to make me hostile.
> > There is one thing I have been trying lately for sleep soundness and it is adding a tiny dose of Melatonin (200 micrograms) at bedtime, and it seems to be helping. Another thing I really want to investigate is Omega3 stuff. I tried the "fish oil" gelcaps-YUCK-I have heartburn and it was pretty nasty. I heard that flaxseed oil has high Omega3 fatty acids and isn't "fishy". The reason I bring that thing up is I have heard it helps kids with ADHD as well as bipolar.
>
> I have used melatonin before. I am a bit leery of it though, since it can be depressogenic. And it's not known to help with early morning wakening, etc. But if I need to shut down the brain so I can fall asleep, I think it's a good remedy as needed. I might have to go digging in the medicine cabinet and haul that one out for a try...
>
> In terms of fish oil, I take 2 grams(capsules) every night *right* before bed. I do not want them to start digesting until I am asleep. Burping fish oil is one of the most unpleasant experiences there is! I never take them during waking moments! I have no idea if they do anything for mood stabilization, etc. But I have heard that they are good for people with skin problems, ezcema and the like, which is me! It's been part of my routine for years now...So I guess it's not much help for the URC! I too want to try some flax seed oil. It does seem more benign than the fish oil. Though I really don't notices it anymore, since I take it right before bed.
>
> Are you completely off the WB now?
> Thanks
> Chloe
Oh, I have more than heartburn it is GERD. I can't eat anything less than 2 hrs before bedtime, even a fairly large meal has to be eaten at least 4 hrs before sleeping. There's no way I could dump a bump of fish fat down the hatch before I go to sleep! I will have to check out the flax seed stuff and see if I can notice it during the middle of the day.Oh, the WB. I am just taking a 1/4 of a 75mg tablet in the morning right after I wake up. If I take more it is disrupting my sleep. I really want to get switched from the WB to a very low dose standard stimulant (with my current med mix). I actually *want* something with a *very* short half-life that I can take with my morning and afternoon Neurontin doses. I would like to try a tiny dose of the new Focalin (dexmethylphenidate)-I wonder if it is like how Dexedrine is to Adderall. I feel a battle with my pdoc over this one. It is nice to have something that doesn't aggravate cycling and *goes away* before I have to sleep!
Mitch
Posted by Chloe on February 3, 2002, at 9:39:01
In reply to Re:TCA/depakote/sleep? » Chloe, posted by Ritch on February 1, 2002, at 22:22:06
Hi Mitch,
Thanks for the last post. I guess sneaking in some fish oil before bed is not a good idea in your case.I tried the depakote 125 mgs, 10:30am and pm. It really did not disrupt my day at all until I got home after 5 pm. Then I felt slightly tired, and thought I might nap. NO WAY. I just can't seem to shut off on depakote. So I started doing stuff, and had a really bad temper/screaming outburst. This surprised me. I hoped all that crap was behind me. But it did not last long.
Anyway, when I went to bed, I could NOT fall asleep for an hour. Then I must have woken up every hour all night long. It was miserable. I would have vivid dreams and wake up disgruntled that it's only been an hour or so of restless sleep. Then this am, I didn't want to get up...But of course the dog really need to go out, and fast this morning, figures!
So, I wonder if you have any thoughts about this? Is this insomnia going to continue to worsen? And am I going to continue to feel disagreeable and grumpy? Or has the dep not had enough time to "work" and smooth things out yet? My impression was that dep was supposed to help with anxiety and sleep. I am not feeling terrilby quiet inside and my sleep is worse than it's been in years...I wish I could get a hold of the pdoc. But I imagine she has no experience with this reaction. I am always having reactions she is not famililar with.
Should I stay the course with the 250? Or back down to 125 at 8 pm. Or try to just stay at 125 dep and increase my neurontin if I can tolerate it. That is more calming. But N really does nothing for the outburst or cycling. Damn, there is just not miracle cure for me.
Sorry this is so long and full of questions that are probably unanswerable!
Take care,
Chloe
Posted by Ritch on February 3, 2002, at 9:56:01
In reply to Re:depakote/insomnia! » Ritch, posted by Chloe on February 3, 2002, at 9:39:01
> Hi Mitch,
> Thanks for the last post. I guess sneaking in some fish oil before bed is not a good idea in your case.
>
> I tried the depakote 125 mgs, 10:30am and pm. It really did not disrupt my day at all until I got home after 5 pm. Then I felt slightly tired, and thought I might nap. NO WAY. I just can't seem to shut off on depakote. So I started doing stuff, and had a really bad temper/screaming outburst. This surprised me. I hoped all that crap was behind me. But it did not last long.
>
> Anyway, when I went to bed, I could NOT fall asleep for an hour. Then I must have woken up every hour all night long. It was miserable. I would have vivid dreams and wake up disgruntled that it's only been an hour or so of restless sleep. Then this am, I didn't want to get up...But of course the dog really need to go out, and fast this morning, figures!
>
> So, I wonder if you have any thoughts about this? Is this insomnia going to continue to worsen? And am I going to continue to feel disagreeable and grumpy? Or has the dep not had enough time to "work" and smooth things out yet? My impression was that dep was supposed to help with anxiety and sleep. I am not feeling terrilby quiet inside and my sleep is worse than it's been in years...I wish I could get a hold of the pdoc. But I imagine she has no experience with this reaction. I am always having reactions she is not famililar with.
>
> Should I stay the course with the 250? Or back down to 125 at 8 pm. Or try to just stay at 125 dep and increase my neurontin if I can tolerate it. That is more calming. But N really does nothing for the outburst or cycling. Damn, there is just not miracle cure for me.
>
> Sorry this is so long and full of questions that are probably unanswerable!
> Take care,
> Chloe
I suppose it is entirely possible that Depakote might cause insomnia-but I really doubt it. If your pdoc wants you to stay at 250mg-I'd stick with it and see how it goes. If it doesn't seem to be "helping" you sleep that much-you might try your idea of splitting the dose 12 hrs. apart-taking one tab at bedtime and the the other at midday the next day. I didn't get very fatigued on Depakote until I got to 500mg/day. But, I still had trouble with munchies at *any* dose.Gee, I wonder if your amitriptyline dosage *decrease* from 20mg > 10mg at bedtime might have something to do with it?
BTW, I'm trying one gelcap at lunch (that contains about 1G of Omega-3) now and I don't notice any significant reflux like I did with the fish oil. Of course, it may do NOTHING, but that's ok.
Mitch
Posted by Chloe on February 6, 2002, at 17:47:05
In reply to Re:depakote/insomnia! » Chloe, posted by Ritch on February 3, 2002, at 9:56:01
> I suppose it is entirely possible that Depakote might cause insomnia-but I really doubt it. If your pdoc wants you to stay at 250mg-I'd stick with it and see how it goes. If it doesn't seem to be "helping" you sleep that much-you might try your idea of splitting the dose 12 hrs. apart-taking one tab at bedtime and the the other at midday the next day. I didn't get very fatigued on Depakote until I got to 500mg/day. But, I still had trouble with munchies at *any* dose.
>
> Gee, I wonder if your amitriptyline dosage *decrease* from 20mg > 10mg at bedtime might have something to do with it?
>
> BTW, I'm trying one gelcap at lunch (that contains about 1G of Omega-3) now and I don't notice any significant reflux like I did with the fish oil. Of course, it may do NOTHING, but that's ok.
>
> MitchHey Mitch,
I think the depakote is finally starting to "kick in." Just the last two nights or so I have been sleeping more soundly and longer, which is nice. I must have really been in a very agitated state. Because now I am starting to feel quite "mellowed" which is a nice change from anger and constant irritation.
You were right about not needing the Neurontin as often. However, I find if I skip my 5pm dose, around 8 pm I start to get the shakes and sweats...But my next dose is around 10:30 or 11pm. So I wonder how to manage this one. If I should just keep taking it at 5p or what...I have tried to talk to my pdoc about dosing of meds and timing to avoid scalp pain etc. No response, or some weird answer that is totally not what I asked. I am afraid she is very busy. I am just so glad I have the meds, and I can try to figure out the best dosing for my needs. But it sure is trial by fire!
For example, I started taking all 250 dep. hs since I was sleeping better, and with in 24 hours I got increased burning scalp. So either I should wait it out, and see if my body adjusts to the whole dose at one time, or divide it at supper and hs. My thought was maybe I need to bump up the ami for a couple of days to quiet the nerves in my scalp. But not stay at 20mgs for more than a few days or a week. I don't want the AD effect to kick in and start the cycling and rages again. Any thoughts on this one?
I really have to wonder though: Why is it, when I take a the right amount of meds for my brain/stability, my scalp and skin start to burn? It is just NOT fair. Mood stabilizers are really hard on my body. I really have trouble tolerating them for any length of time. But I have to find a way to stay compliant this time. All these meds changes have taken a toll. I want to stay on this for a good long while...
How are you doing in the pstim department? I will check the other thread to see how you are doing with the flaxseed oil. I added that to my fish oil and I love it. Much more palliable. I think I will switch over.
Thanks
Chloe
Posted by Ritch on February 6, 2002, at 23:49:10
In reply to Re:depakote/med musings » Ritch, posted by Chloe on February 6, 2002, at 17:47:05
> Hey Mitch,
>
> I think the depakote is finally starting to "kick in." Just the last two nights or so I have been sleeping more soundly and longer, which is nice. I must have really been in a very agitated state. Because now I am starting to feel quite "mellowed" which is a nice change from anger and constant irritation.
Yes, it does take a little while for it to start to work. I can notice some immediate effects with a relatively larger dose, but it would take a week or two to notice much on chronic low-dosing. Yes, the lack of anger and constant irritation is a nice blissful place indeed.
>
> You were right about not needing the Neurontin as often. However, I find if I skip my 5pm dose, around 8 pm I start to get the shakes and sweats...But my next dose is around 10:30 or 11pm. So I wonder how to manage this one. If I should just keep taking it at 5p or what...I have tried to talk to my pdoc about dosing of meds and timing to avoid scalp pain etc. No response, or some weird answer that is totally not what I asked. I am afraid she is very busy. I am just so glad I have the meds, and I can try to figure out the best dosing for my needs. But it sure is trial by fire!
Yes, just about everything I have learned and discovered has been mostly by trial and error, no pdoc's genius has intervened to save the day in one fell swoop. It is actually easier just to get them to prescribe the meds (several of the "candidates") and just let you experiment and tinker with them and do your own self-adjusting and then just accurately tell them what is working with charts as necessary (my experience-just try to stay scientific as possible-change just one thing at a time, but feel free to make the changes relatively frequently). It sounds like you will probably have to stick with the 100mg x4 dosage, unless you are willing to make the jump to 300mg twice daily. I think you might find that to work quite well. When I was on higher doses, Neurontin 300mg bid + Depakote 125-250mg bid worked together seamlessly.
>
> For example, I started taking all 250 dep. hs since I was sleeping better, and with in 24 hours I got increased burning scalp. So either I should wait it out, and see if my body adjusts to the whole dose at one time, or divide it at supper and hs. My thought was maybe I need to bump up the ami for a couple of days to quiet the nerves in my scalp. But not stay at 20mgs for more than a few days or a week. I don't want the AD effect to kick in and start the cycling and rages again. Any thoughts on this one?> I really have to wonder though: Why is it, when I take a the right amount of meds for my brain/stability, my scalp and skin start to burn? It is just NOT fair. Mood stabilizers are really hard on my body. I really have trouble tolerating them for any length of time. But I have to find a way to stay compliant this time. All these meds changes have taken a toll. I want to stay on this for a good long while...
If you know *for sure* that the amitripytline is helping your neuropathic scalp pain-why not count it as an "in med"? If you are starting to get smoothed out by the Dep. you very possibly could double up the amitrip. to 20mg at bedtime and sleep better as well as reduce the pain probs. without any destabilization.
> How are you doing in the pstim department? I will check the other thread to see how you are doing with the flaxseed oil. I added that to my fish oil and I love it. Much more palliable. I think I will switch over.
> Thanks
> Chloe
Well the flax oil *does* seem to be helping some. But it is causing some GI discomfort. I tried Lorraine's suggestion of sublingual B-complex liquid and strangely after about an hour after taking it I got very relaxed and calmed. I thought I would kind of *wired* on it but didn't. The B-12 was definite megadose.Mitch
Posted by Chloe on February 7, 2002, at 18:26:14
In reply to Re:depakote/med musings » Chloe, posted by Ritch on February 6, 2002, at 23:49:10
\
> Yes, just about everything I have learned and discovered has been mostly by trial and error, no pdoc's genius has intervened to save the day in one fell swoop. It is actually easier just to get them to prescribe the meds (several of the "candidates") and just let you experiment and tinker with them and do your own self-adjusting and then just accurately tell them what is working with charts as necessary (my experience-just try to stay scientific as possible-change just one thing at a time, but feel free to make the changes relatively frequently). It sounds like you will probably have to stick with the 100mg x4 dosage, unless you are willing to make the jump to 300mg twice daily. I think you might find that to work quite well. When I was on higher doses, Neurontin 300mg bid + Depakote 125-250mg bid worked together seamlessly.Hi Mitch,
I would like very much to go up on the neurontin, but I really think it adds to my scalp burning/pain. Just going up by 100 mgs seems to have a profound effect. Even splitting the 400 to BID, taking the full 200 in the am seems to make my scalp pain worse during the day. I wonder if putting too much med (in me) at one time, ie too dramatic a blood level increase causes the scalp thing. I am really trying to figure this out...So for now, I am thinking I will just leave my neurontin the way it is and WAIT...and hope the pain gets better. But so far it's getting worse.> If you know *for sure* that the amitripytline is helping your neuropathic scalp pain-why not count it as an "in med"? If you are starting to get smoothed out by the Dep. you very possibly could double up the amitrip. to 20mg at bedtime and sleep better as well as reduce the pain probs. without any destabilization.
Well I wish I knew *for sure*! But it really did calm things down at 20 mgs. But ami really does seem to increase my rage and cycling episodes. I just have to decide if it's worth experimenting with my stability to decrease the scalp discomfort...I thinking I may give it a whirl tonight. I will see how brave I feel around bedtime!
> Well the flax oil *does* seem to be helping some. But it is causing some GI discomfort. I tried Lorraine's suggestion of sublingual B-complex liquid and strangely after about an hour after taking it I got very relaxed and calmed. I thought I would kind of *wired* on it but didn't. The B-12 was definite megadose.I concur that flax seed oil is harder on the gut than the fish oil. I never noticed any change with fish oil. But with flax seed, I find it has some laxative properties (though not always a bad thing with some of my meds!)
I had a nutritionist tell me to never take B vitamins before bed. That they can be "energizing." I am so glad you experienced a calm and *cool* feeling. But do be careful with megadoses. Our bodies are under alot of stress as it is with our emotional chemistry and the meds we throw on top of it!Thanks so much, Mitch
Chloe
Posted by Ritch on February 8, 2002, at 0:05:15
In reply to Re:depakote/med musings » Ritch, posted by Chloe on February 7, 2002, at 18:26:14
This is the end of the thread.
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