Posted by Robert_Burton_1621 on February 14, 2015, at 7:33:20
In reply to Sleep, FOOD, fluids and hypotension. » Robert_Burton_1621, posted by ed_uk2010 on February 13, 2015, at 11:33:58
> To detect postural hypotension with a home BP monitor, .....>
This is extremely practically helpful. I was told to measure my orthstatic BP, but not told how to do so optimally (or even adequately).
I appreciate your advice on hydration and calorie intake. I agree (from what you've explained) that my lack of calories over the last three days is likely to be the main problem.
In regards to fluids - and dehydration - for the sake of full-disclosure, and at the risk of embarassment, I am having difficulty with alcohol. This has been a long-standing issue. I only drink at night, probably 7 standard drinks. I suppose Oprah would assess me as "self-medicating". And she'd be right. I am only drinking white wine since the move to parnate. But I don't want to, and I know that it is just another confounding factor. To be honest, I was secretely hoping that, being on parnate, I would not be able to tolerate *any* alcohol: that would have been an absolute barrier. I am going to stop it all from tomorrow.
As a side note, the astonishing thing about Effexor when it worked was that it not eradicated any *desire* for alcohol; i.e., it just didn't help me in avoiding the temptation, but totally eliminated the temptation itself. It do so within a week and I was alcohol free for close to six months.
I do live alone and alas there's no one I can call on to give me a hand. Or rather, there's no-one whom I would be *willing* to ask (a qualification which points perhaps to a pride or shame on my part). Outside of medical or uni officers (to whom I was required to disclose it), I have told no family and only one friend of my condition. As for the later, though he has known me for 20 years, he affected disbelief. He had a brief episode of depression himself years ago and recovered immediately on fluoxetine. I suspect he assumes that his experience of recovery would be replicable if I were genuine. It's because of the likelihood of reactions like this that I am very reluctant to disclose the severity of my depression or even that I am affected by it.
Be that as it may, what I think I will do is prepare some meals in advance and freeze them, so I can eat even if I am feeling weak.
I was interested in your stress on high-calorie meals. Was this made for the purpose of negating quickly my minimum-calorie consumption over the last three days, or because there's something about Parnate which makes a (within reason) high-calorie diet beneficial or important?
> Temazepam is often helpful for short-term or 'as needed' use. How much are you taking, 10-20mg?>
That's right, I've been told to take one or two tablets, up to 20mg. I took one and it had no effect, and two had a small effect though it was already 5am then and I suspect I may have fallen asleep soon thereafter anyway!
I've had some itching from the temazepam, I assume - scalp, eyes, ears, lips, tongue. It's not unbearable, but it is annoying.
Thanks for the list of alternatives. Would you consider doxepin potentially useful? We can't get trazadone here in Australia.
Mirtazapine (small dose) knocked me out in 15 minutes when i was taking it at night with Effexor. Is taking that out of the question?
Sorry - I'm imposing on you with all of these questions!
> Pizotifen is a serotonin antagonist yes, at 5-HT2a and 2c. It is related to the tricyclic antidepressants and I'm not sure how thoroughly its reuptake inhibitor potency has been studied... probably not much! I do not believe it's a serotonin reuptake inhibitor but the pharmacology of many old drugs is not well known.>I see; that's instructive. The odd thing is that, i know pizotifen is prescribed as a prophylactic, but when I took it it actually "cured" the transformed-migrainous state I was in for many weeks - overnight.
I have just learnt from your comment that it's possible for something to be a serotonin antagonist and yet have serotonin reuptake inhibition as well. My "common-sense" would have concluded these properties were mutually exclusive. I do have a lot to learn.
> I think it would be best to wait a few weeks in order to determine whether any additional drugs are needed for headache prophylaxis.>
I agree.
> Good luck!
Thanks, again!
poster:Robert_Burton_1621
thread:1075968
URL: http://www.dr-bob.org/babble/20150129/msgs/1076583.html