![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by linkadge on July 16, 2007, at 19:46:34
My mother is currently taking:
lithium 1050mg
Seroquel 50mg
trazodone 450mg
tryptophan 5 grams
hydroxyzine ?mg
tegretol 200mgIt is a terrable situation. She sleeps most of the day and has broken sleep/pacing at night. She cries most of the day and says she is in hell.
I personally think she is taking too much and might do better on less. Some of the meds are probably making others toxic, ie seroquel + lithium.
I am also concerned that the tryptophan might be interacting with the lithium and trazodone to be causing serotonin syndrome.
There is a lot of discrepensy. She doesn't my opinion so she takes whatever the doctor tells her to, but I think she is getting worse. I don't know how to help the situation.
Linkadge
I am having great difficulty reconciling issues with
Posted by Phillipa on July 16, 2007, at 21:47:20
In reply to help with mothers meds (interactions?), posted by linkadge on July 16, 2007, at 19:46:34
Link is there anyway you can talk to her doc? Can you get her lithium level? I remember you once saying it was too high . Your poor Mother and you. It does sound like a lot of meds but I don't have the knowledge you do. Did you contact Lar? Love Phillipa
Posted by med_empowered on July 17, 2007, at 0:37:46
In reply to help with mothers meds (interactions?), posted by linkadge on July 16, 2007, at 19:46:34
wow. that's a pretty intense combo. Do you think she has either akathisia or tardive akathisia? The late nite agitation is kind of consistent with that, although it could be part of a severe depressive episode.
Has your mom ever been on a benzo? I'm not a doc, but it seems like if you could drop alot of stuff (tryptophan, trazadone, hydroxyzine) in place of a tranquilizer, maybe plus a hypnotic, your mom would feel better, and you could get a better feel for what was going on.
Does your mom like lithium? Or tegretol? Since she's female and has affective illness, its probably a good idea to avoid a neuroleptic, and a neuroleptic-lithium combo seems even more likely to cause problems but...do you think she might feel better on just a neuroleptic for mood stabilization, plus whatever else for anxety/agitation?
Anyway, sorry about the situation.
Posted by polarbear206 on July 17, 2007, at 13:17:12
In reply to help with mothers meds (interactions?), posted by linkadge on July 16, 2007, at 19:46:34
> My mother is currently taking:
>
> lithium 1050mg
> Seroquel 50mg
> trazodone 450mg
> tryptophan 5 grams
> hydroxyzine ?mg
> tegretol 200mg
>
> It is a terrable situation. She sleeps most of the day and has broken sleep/pacing at night. She cries most of the day and says she is in hell.
>
> I personally think she is taking too much and might do better on less. Some of the meds are probably making others toxic, ie seroquel + lithium.
>
> I am also concerned that the tryptophan might be interacting with the lithium and trazodone to be causing serotonin syndrome.
>
> There is a lot of discrepensy. She doesn't my opinion so she takes whatever the doctor tells her to, but I think she is getting worse. I don't know how to help the situation.
>
> Linkadge
>
>
>
>
>
>
>
>
>
>
>
> I am having great difficulty reconciling issues withTegretal is related to the cyclic antidepressants and can cause increase central nervous system toxicity when combined with lithium. All of these medications is bound to cause adverse reactions. I don't understand the p-doc's logic combining three mood stabilizer?? Do you know her last serum lithium level?
Polarbear
Posted by linkadge on July 17, 2007, at 16:14:59
In reply to Re: help with mothers meds (interactions?), posted by med_empowered on July 17, 2007, at 0:37:46
>Do you think she has either akathisia or tardive >akathisia?
Yeah, thorazine shuffle, plus lip smaking, and an occasional random nodding type of head movement.
>The late nite agitation is kind of consistent >with that, although it could be part of a severe >depressive episode.
The problem is the trazodone, I think. It is sedating her but making sleep very broken.
>Has your mom ever been on a benzo? I'm not a >doc, but it seems like if you could drop alot of >stuff (tryptophan, trazadone, hydroxyzine) in >place of a tranquilizer, maybe plus a hypnotic, >your mom would feel better, and you could get a >better feel for what was going on.
Funny you should suggest that. This new doctor is a benzophobe and told her to get off xanax (as it was addictive) and has since replaced it with trazodone, tegretol, tryptophan. She was doing better on the xanax.
There is no way to justify that move except arrogence and ignorance.
>Does your mom like lithium? Or tegretol? Since >she's female and has affective illness, its >probably a good idea to avoid a neuroleptic, and >a neuroleptic-lithium combo seems even more >likely to cause problems but...do you think she >might feel better on just a neuroleptic for mood >stabilization, plus whatever else for >anxety/agitation?The tegretol was a recent addition. She's been on lithium for like 30 years. We also just added the seroquel. She is sensitive to AP cognative impairment.
>Anyway, sorry about the situation.Thanks for the input.
Linkadge
Posted by linkadge on July 17, 2007, at 16:17:59
In reply to Re: help with mothers meds (interactions?), posted by polarbear206 on July 17, 2007, at 13:17:12
Her serum is just barely theraputic if not subtheraputic. The problem is that she has always done better on less lithium. She had been stable on 600mg for the longest time, and only now this new doctor wants her on more. Every time she goes up to a theraputic dose the side effects are intollerable, and crippling depression sets in.
I am afraid that this doctor is just taking advantage of her on account of her state.
Posted by Nathan_Arizona on July 17, 2007, at 19:11:50
In reply to help with mothers meds (interactions?), posted by linkadge on July 16, 2007, at 19:46:34
After reading that list, it is no wonder that your mom says she is in hell.
450 mgs of trazadone?
All of her meds just seem off the charts to me. Is there a chance of getting her to see another doctor? One that might reconsider the xanax?
I'm so sorry this has happened to you both.
Posted by Abby Cunningham on July 18, 2007, at 9:24:49
In reply to Re: help with mothers meds (interactions?) » linkadge, posted by Nathan_Arizona on July 17, 2007, at 19:11:50
Link, was she tapered off the Xanax very slowly, even with other meds added, she could still be experiencing w/d from the benzo which can be hell in itself. Just a thought.
Abby
Posted by linkadge on July 18, 2007, at 9:47:02
In reply to Re: help with mothers meds (interactions?), posted by Abby Cunningham on July 18, 2007, at 9:24:49
She was tapered off slowly, but the problem is that I don't think the other meds are helping her anxiety like xanax was.
He said he doesn't use benzodiazapines cause they are addictive and cause cognative impairment, then proceeded to replace it with like 4 other drugs.
Linkadge
Posted by Sigismund on July 18, 2007, at 15:35:43
In reply to Re: help with mothers meds (interactions?), posted by linkadge on July 18, 2007, at 9:47:02
>He said he doesn't use benzodiazapines cause they are addictive and cause cognitave impairment
While this is true, your mother is so ill that it seems ridiculous to have as a consideration.
Still, an 85yo terminally ill friend was withdrawn from her oxycodone because it was addictive.
Posted by linkadge on July 18, 2007, at 20:44:52
In reply to Re: help with mothers meds (interactions?), posted by Sigismund on July 18, 2007, at 15:35:43
>Still, an 85yo terminally ill friend was >withdrawn from her oxycodone because it was >addictive.
Such kinds of doctors make me sick. Over in Brittain, isn't it legal to use Heroin in cases where the patient is termanally ill?
In my mind, a doctor should prescribe whatever meds a terminally ill patient wants, at ever increasing doses if necessary, so that the patient at least can die in comfort.
Its like "Hey, I have respect for human life, I am going to just make a patient who is already going throug hell (with terminall illness) and put them through more hell, (drug withdrawl).
Linkadge
Posted by Phillipa on July 18, 2007, at 20:51:14
In reply to Re: help with mothers meds (interactions?) » Sigismund, posted by linkadge on July 18, 2007, at 20:44:52
Link it's disgusting to make a person suffer with pain when they are dying. I wonder if depression and anxiety where meds don't work is dying too? Love Phillipa
Posted by Sigismund on July 19, 2007, at 3:05:06
In reply to Re: help with mothers meds (interactions?) » Sigismund, posted by linkadge on July 18, 2007, at 20:44:52
This doctor was English (in Australia) and he actually said
'she needs someone to stand up to her'.One law for the rich and one for the poor.
Posted by linkadge on July 19, 2007, at 8:26:48
In reply to Re: help with mothers meds (interactions?) » linkadge, posted by Sigismund on July 19, 2007, at 3:05:06
>This doctor was English (in Australia) and he >actually said 'she needs someone to stand up to >her'.
I hope when that guy is dying, he has some medical issue that requires strong pain meds, and that some other doctor decides to make his last while even more hell by forcing him to go through withdrawl.
Sometimes I think doctors have lost the point.
Linkadge
This is the end of the thread.
Psycho-Babble Medication | 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.