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Re: I'm bored, list of stims, Seroquel Sad Panda

Posted by Cairo on July 19, 2004, at 21:29:29

In reply to Re: I'm bored, list of stims, Seroquel Cairo, posted by Sad Panda on July 17, 2004, at 10:54:34

> Has she been to an endocrinologist? Adding thyroxine is one of the few things that doesn't seem to have a downside. Does she sleep poorly on Trazodone?
>
> Cheers,
> Panda.

Not officially, but both her Rheumatologist and my endocrinologist have said that since her TSH, T3 and T4 are normal (TSH under 2), then giving T3 or T4 would not be wise because of negative feedback to the thyroid. It was the Rheumatologist who suggested that HPA axis hypofunction might be responsible for her delayed menses and there is another problem in the loop, perhaps elevated cortisol or CRH hypersecretion.

I know of someone who started on T3 and felt great for a short while, but later crashed and her thyroid shut down. I think using T3 would only be treating something "downstream" anyway.

I'm really not sure if her sleep is restful on the Trazodone. She has usually slept through the night even before taking Traz, but I don't think the quality is there and she definitely has a sleep phase shift. We'd need to repeat the sleep study to see what Trazodone is doing. And AD can cause/aggravate sleep apnea, so it's a catch 22. I think I read that only Xyrem can induce stage 3 sleep. I don't anything about it, but I'd want to eliminate other stressors before I would consider that anyway.

I wonder if they would consider a TCA; she was much younger when they tried imipramine and the dose may have been too high (tachycardia) given the sensitivity that some fibromyalgia patients have to meds.

One thing is for sure, Lexapro is only partially effective at 20mg. Her mood and sociability are somewhat better, but she still looks depressed, her appetite is not picking up and the SP hasn't been helped much.

She is a puzzle, but we love her.

Cairo


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