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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Simcha on November 7, 2002, at 23:47:52
Well, I'll try to post this again.
I'm starting Neurontin tonight. I'm taking 100mg tonight and I'm increasing the dose by 100mg per night until I feel that the Neurontin is having some effect and/or I experience side effects. I don't know where this will be. It's an experiment.
This pdoc thinks that Neurontin will be a better choice to treat the Bruxism than the Klonipin. He also thinks that Neurontin will add something to my Celexa/WellbutrinSR mix by augmenting the current antidepressants. He's also said something about maybe switching to a Tricyclic if this does not work because Tricyclics don't add to Bruxism.
He says he's not concerned that I will suffer Klonopin withdrawal because I've missed my 1mg dose a few times with no ill side effects. So he's having me take only .5mg per night until the Neurontin kicks in. Then he said that I could take the Klonopin on an "as needed" basis if I feel anxious. So he's not "benzophobic."
Mainly he had issue with the Klonopin because of my sleep patterns (not good). The Klonopin is supposed to cause an abnormal sleep architecture. I've read that here and elsewhere. Also he says that anecdotally it might add to depression. He felt that the last pdoc was using a "sledge hammer" to treat Bruxism.
He was having me read about Topamax because he thought that I might be bipolar. He just got my charts from the old pdoc and he thinks that there is still a chance. He gave me a book "Dr. Fieve on Depression: Moodswing." It's the second edition 1997. He wants me to read the book and he wants me to examine my life to see if I have cycles of depression and mania. I don't remember having mania yet some of my actions could be classified manic sometimes. Therefore he wanted me to be certain as to what manic really meant.
Basically I feel comfortable with this pdoc because he wants me to be an educated consumer. Also he said that I will be an integral part of the decision making process where diagnosis and treatment is concerned. I really like that.
Anyway, I'll let you all know how the Neurontin trial goes.
Simcha
Posted by Simcha on November 9, 2002, at 11:11:21
In reply to Starting Neurontin, posted by Simcha on November 7, 2002, at 23:47:52
Today, is day two of the trial. I'm not sure what I should do. I've cut the Klonopin down to .5mg at night. Last night I took 200mg of Neurontin.
On Friday, after taking 100mg the night before, I did feel very good during the mid-morning and early afternoon. I did have a restful sleep. I was a bit dopey during the day. I'm not sure if that's a side-effect or what.
Today, after taking 200mg the night before, I feel a bit sedated and my body feels slightly numb. My mood feels rested and I feel very mellow. I'm going to take a nap now because, well, it's Saturday, and I feel slightly drowsy.
My pdoc told me that I can experiment with the Neurontin. I'm using it primarily for Bruxism, which seems to be anxiety related and it was made worse with the addition of Celexa to my mix. He told me to stop at the level that I feel an effect. I'm feeling some effects. He did tell me that some people do just fine with 100mg per night.
I've read all over the place that it might take some time before I feel the full benefits of Neurontin. Also it seems that most people are on more Neurontin than me and that it might be more effective at higher doses.
I'm not sure if I should take the 300mg as scheduled tonight or stick to 200mg.
Does anyone have experience with this drug who could advise?
My pdoc doesn't have weekend hours even though I could page him if this were an emergency. I don't feel that this is an emergency because I could easily stop where I am and call him on Monday.
Or, I can continue increqsing the dosage 100mg per night to see what happens. I'm tempted to see what happens today and guage it. I'll make a decision tonight, of course.
What do all of you who have experience with Neurontin have to say?
Thanks in advance,
Simcha
Posted by Ritch on November 9, 2002, at 17:42:14
In reply to Re: Starting Neurontin -- Update Please Advise!, posted by Simcha on November 9, 2002, at 11:11:21
> Today, is day two of the trial. I'm not sure what I should do. I've cut the Klonopin down to .5mg at night. Last night I took 200mg of Neurontin.
>
> On Friday, after taking 100mg the night before, I did feel very good during the mid-morning and early afternoon. I did have a restful sleep. I was a bit dopey during the day. I'm not sure if that's a side-effect or what.
>
> Today, after taking 200mg the night before, I feel a bit sedated and my body feels slightly numb. My mood feels rested and I feel very mellow. I'm going to take a nap now because, well, it's Saturday, and I feel slightly drowsy.
>
> My pdoc told me that I can experiment with the Neurontin. I'm using it primarily for Bruxism, which seems to be anxiety related and it was made worse with the addition of Celexa to my mix. He told me to stop at the level that I feel an effect. I'm feeling some effects. He did tell me that some people do just fine with 100mg per night.
>
> I've read all over the place that it might take some time before I feel the full benefits of Neurontin. Also it seems that most people are on more Neurontin than me and that it might be more effective at higher doses.
>
> I'm not sure if I should take the 300mg as scheduled tonight or stick to 200mg.
>
> Does anyone have experience with this drug who could advise?
>
> My pdoc doesn't have weekend hours even though I could page him if this were an emergency. I don't feel that this is an emergency because I could easily stop where I am and call him on Monday.
>
> Or, I can continue increqsing the dosage 100mg per night to see what happens. I'm tempted to see what happens today and guage it. I'll make a decision tonight, of course.
>
> What do all of you who have experience with Neurontin have to say?
>
> Thanks in advance,
> Simcha
Simcha,I would just trust your own feelings. If you are resting OK and the Neurontin isn't making you feel too zoned out in the mornings at work you could try 300mg at bedtime. Just a suggestion, but if you have cut the Klonopin in half to .5mg, it may take a couple of weeks before the level of Klonopin reaches a steady state. Perhaps target 300mg of Neurontin + .5mg of Klonopin at bedtime for a couple of weeks and see how the bruxism goes?? You won't know if Neurontin will 'replace' Klonopin for your bruxism until you aren't taking Klonopin any longer and you aren't in a *withdrawal symdrome* from the Klonopin. When I was taking higher doses of Neurontin, 400mg+ for a single dose was just too much of a whallop for me.
good luck,
Mitch
Posted by Simcha on November 9, 2002, at 18:20:50
In reply to Re: Starting Neurontin -- Update Please Advise! » Simcha, posted by Ritch on November 9, 2002, at 17:42:14
Mitch,
Yeah, well, after 200mg last night I'm definitely still feeling the effects today at 4:15pm.
I'm going to try the 300mg tonight with the .5mg of Klonopin (I don't have to work tomorrow or Monday). On Monday I will call my pdoc and suggest that we keep the levels here for a couple of weeks if all goes well. If not I will suggest that we keep the levels at 200mg for the next few weeks so that I might see how it plays out. Then we can work on cutting the Klonopin on a nightly basis and have it just on an "as needed" basis to see what effect that has and work from there.
I'm finding that Neurontin is a powerful drug that almost makes me feel drunk on my current mix as I type this. I'm amazed that there are people who take 1gram+ tid! I'd be a zombie I think! lol
I think that my mix will be:
40mg Celexa
200mg WellbutrinSR
300mg Neurontin at night
.5mg of Klonopin at nightI'll keep all of you informed as to what happens.
Take Care,
SimchaMed changes just suck....
> I would just trust your own feelings. If you are resting OK and the Neurontin isn't making you feel too zoned out in the mornings at work you could try 300mg at bedtime. Just a suggestion, but if you have cut the Klonopin in half to .5mg, it may take a couple of weeks before the level of Klonopin reaches a steady state. Perhaps target 300mg of Neurontin + .5mg of Klonopin at bedtime for a couple of weeks and see how the bruxism goes?? You won't know if Neurontin will 'replace' Klonopin for your bruxism until you aren't taking Klonopin any longer and you aren't in a *withdrawal symdrome* from the Klonopin. When I was taking higher doses of Neurontin, 400mg+ for a single dose was just too much of a whallop for me.
>
> good luck,
> Mitch
Posted by Simcha on November 10, 2002, at 14:29:29
In reply to Re: Starting Neurontin -- Update Please Advise! » Ritch, posted by Simcha on November 9, 2002, at 18:20:50
OK folks,
I took 300mg last night and I did sleep longer than usual. I feel pretty good at the present writing this. I do wonder if some of the symptoms of yesterday morning were more related to Klonopin withdrawal than to increasing Neurontin.
However, I went to a party last night. I got there at around 5:00pm and I still felt somewhat drunk (I think on Neurontin). Everyone else at the party was drinking alcohol but me. I have decided that alcohol and my medication do not mix well. I did feel a bit left out but I had a good time nonetheless. I left said party at 9:30pm because I thought it might be a good idea to get home early enough to try to keep the same sleep schedule that I have during the week.
Since I feel pretty good today, maybe I should up the Neurontin to 400mg tonight? I don't know. I might just take the 300mg and call the pdoc tomorrow to report my findings and to ask about Klonopin withdrawal during this process and how it might cloud what is happening with the Neurontin.
So, tonight I think it will be 300mg of Neurontin with .5mg of Klonopin again.
From what I'm reading on the Klonopin withdrawal thread it might be a good idea to cut the .5 in half on Friday (7 days after I went from 1mg to .5mg) rather than going cold turkey sooner. I'll ask my pdoc about that too.
Thanks for all of the great advise and information on this board. You all have really helped me to get clear about my need for medication and you have given me the support I need to continue treatment.
As I read about bipolar and I just watched Dr. Gershon's presentation, I'm thinking that I have Major Depressive Disorder, or Unipolar Depression, rather than Bipolar Disorder. I do not seem to have the highs associated with Bipolar Disorder. I did find it interesting that in families where Bipolar Disorder is present, such as my family, that Unipolar Depression can be one of the inherited conditions. I guess it makes sense.
Anyway, thanks everyone. I will continue to report on my progress.
Take Care,
Simcha
Posted by Simcha on November 11, 2002, at 10:03:42
In reply to Re: Starting Neurontin -- 300mg last night..OK, posted by Simcha on November 10, 2002, at 14:29:29
I took the 300mg dose of Neurontin with the .5mg of Klonopin last night and I feel less drowsy today. It's 8:00am.
I'm calling my pdoc today to let him know what is going on with my trial of Neurontin and the cutback of Klonopin. I will let you all know what he says about where I am. I think he's going to agree that I rest at 300mg for now and maybe he'll have me halve the .5mg of Klonopin by Friday.
Take Care,
Simcha
Posted by Simcha on November 11, 2002, at 13:17:37
In reply to Re: Starting Neurontin -- 300mg last night..OK, posted by Simcha on November 11, 2002, at 10:03:42
Folks, I just got off the phone with my pdoc and he says I'm doing well with this trial and that he agrees that I should remain at 300mg if I'm feeling slightly sedated during the day. If the sedation wears off he said I should try 400mg and I'll know if it is too much when I get there and I can go back down to the previous level.
He is also supporting me in my decision to cut the .5mg of Klonopin to .25mg of Klonipin starting Friday night. This way I cut the Klonopin dose 1/2 again after one week of being on 1/2 of my previous dose. He has encouraged me to take as long as I need to to get off of the Klonopin. From what I've read here it might be a good idea to cut the .25mg again in half to .125 yet my 1mg pills would make that difficult. I'll have to see how I feel when I get there.
I'm glad I'm journalling this experience here. It is helping me to track how the switch is going and I can get feedback from others who have tried Neurontin.
Take Care,
Simcha
Posted by Ritch on November 11, 2002, at 20:27:28
In reply to Re: Neurontin -- 300mg Pdoc's Response, posted by Simcha on November 11, 2002, at 13:17:37
> Folks, I just got off the phone with my pdoc and he says I'm doing well with this trial and that he agrees that I should remain at 300mg if I'm feeling slightly sedated during the day. If the sedation wears off he said I should try 400mg and I'll know if it is too much when I get there and I can go back down to the previous level.
>
> He is also supporting me in my decision to cut the .5mg of Klonopin to .25mg of Klonipin starting Friday night. This way I cut the Klonopin dose 1/2 again after one week of being on 1/2 of my previous dose. He has encouraged me to take as long as I need to to get off of the Klonopin. From what I've read here it might be a good idea to cut the .25mg again in half to .125 yet my 1mg pills would make that difficult. I'll have to see how I feel when I get there.
>
> I'm glad I'm journalling this experience here. It is helping me to track how the switch is going and I can get feedback from others who have tried Neurontin.
>
> Take Care,
> Simcha
Simcha,Will your pdoc write for .5mg scored tabs? That would make it a little easier.--Mitch
Posted by Simcha on November 15, 2002, at 22:13:04
In reply to Re: Neurontin -- 300mg Pdoc's Response » Simcha, posted by Ritch on November 11, 2002, at 20:27:28
Ritch,
I'm not sure if he would write a prescription for .5mg tabs of Klonopin. I guess I could ask on Monday when I report what happens when I titrate up to 400mg of Neurontin while going down to .25mg of Klonopin tonight and using only .25mg of Klonopin per night for this next week.
I decided last week to just stay at 300mg of Neurontin for a week. It's been a good week. Tonight I'm reducing the Klonopin so I'll titrate my Neurontin in 100mg increments each night (both tonight and possibly tomorrow night) until the side effects come back and/or I feel it has replaced .25mg of Klonopin.
I'm trying to titrate on weekends so I have time to sleep of drowsiness just in case...
I'll let you all know how this goes...
Simcha
Posted by Ritch on November 16, 2002, at 9:05:12
In reply to Re: Neurontin -- titrate to 400mg down to .25mg Kl, posted by Simcha on November 15, 2002, at 22:13:04
> Ritch,
>
> I'm not sure if he would write a prescription for .5mg tabs of Klonopin. I guess I could ask on Monday when I report what happens when I titrate up to 400mg of Neurontin while going down to .25mg of Klonopin tonight and using only .25mg of Klonopin per night for this next week.
>
> I decided last week to just stay at 300mg of Neurontin for a week. It's been a good week. Tonight I'm reducing the Klonopin so I'll titrate my Neurontin in 100mg increments each night (both tonight and possibly tomorrow night) until the side effects come back and/or I feel it has replaced .25mg of Klonopin.
>
> I'm trying to titrate on weekends so I have time to sleep of drowsiness just in case...
>
> I'll let you all know how this goes...
>
> SimchaSimcha, does your pdoc have an intention on having you dose Neurontin during the daytime as well for possible bipolar, or do you think that he is just staying focused on replacing the Neurontin for Klonopin to treat bruxism?--Mitch
Posted by Simcha on November 16, 2002, at 11:52:47
In reply to Re: Neurontin -- titrate to 400mg down to .25mg Kl » Simcha, posted by Ritch on November 16, 2002, at 9:05:12
Mitch,
> Simcha, does your pdoc have an intention on having you dose Neurontin during the daytime as well for possible bipolar, or do you think that he is just staying focused on replacing the Neurontin for Klonopin to treat bruxism?--Mitch
Actually my pdoc is not leaning toward a bipolar dx. Right now he believes that the diagnosis is unipolar depression (Major Depressive Disorder).
He gave me the book "Moodswing" to read so that I might evaluate my life to see if I identified with any of the cases in the book. I can say that I don't identify with the manic side of the condition at all. I do remember waking up wanting to be dead even as a child. This was an everyday experience before medication. I do remember having at least 4 distinct major depressive episodes.
The pdoc is attempting to use Neurontin to treat the bruxism in replacement of the Klonopin. So far it seems to be working. I'm still on a small dose (.25mg) of the Klonopin at night so we can't be 100% sure if this is going to be a long-term soloution or not.
He did say that Neurontin might help my mood throughout the day. He said that it can increase the effectiveness of the anti-depressants that I'm taking. I'm finding this to be true. He also said that we could even work toward using Neurontin during the day too if I felt that it might be beneficial.
Also he was concerned about my weight. I've lost 7 pounds since I've started the Neurontin and reduced the Klonopin. I've also gotten a bit more exercise on the job. Also I've been eating small meals throughout the day. Therefore it could be a combination of med change and lifestyle change. Also I believe that some of the 7 pounds could be water. I find myself thirstier on Neurontin. I do drink more water but I urinate and sweat a little more too.
All in all I think this trial is going well. I'm satisfied with where this is going for now...
Mitch,
Do you see any problems with the theory in your experience and knowledge of Neurontin?
Thanks,
Simcha
Posted by Ritch on November 16, 2002, at 17:10:46
In reply to Re: Neurontin -- titrate to 400mg down to .25mg Kl » Ritch, posted by Simcha on November 16, 2002, at 11:52:47
> Mitch,
>
> > Simcha, does your pdoc have an intention on having you dose Neurontin during the daytime as well for possible bipolar, or do you think that he is just staying focused on replacing the Neurontin for Klonopin to treat bruxism?--Mitch
>
> Actually my pdoc is not leaning toward a bipolar dx. Right now he believes that the diagnosis is unipolar depression (Major Depressive Disorder).
>
> He gave me the book "Moodswing" to read so that I might evaluate my life to see if I identified with any of the cases in the book. I can say that I don't identify with the manic side of the condition at all. I do remember waking up wanting to be dead even as a child. This was an everyday experience before medication. I do remember having at least 4 distinct major depressive episodes.
>
> The pdoc is attempting to use Neurontin to treat the bruxism in replacement of the Klonopin. So far it seems to be working. I'm still on a small dose (.25mg) of the Klonopin at night so we can't be 100% sure if this is going to be a long-term soloution or not.
>
> He did say that Neurontin might help my mood throughout the day. He said that it can increase the effectiveness of the anti-depressants that I'm taking. I'm finding this to be true. He also said that we could even work toward using Neurontin during the day too if I felt that it might be beneficial.
>
> Also he was concerned about my weight. I've lost 7 pounds since I've started the Neurontin and reduced the Klonopin. I've also gotten a bit more exercise on the job. Also I've been eating small meals throughout the day. Therefore it could be a combination of med change and lifestyle change. Also I believe that some of the 7 pounds could be water. I find myself thirstier on Neurontin. I do drink more water but I urinate and sweat a little more too.
>
> All in all I think this trial is going well. I'm satisfied with where this is going for now...
>
> Mitch,
>
> Do you see any problems with the theory in your experience and knowledge of Neurontin?
>
> Thanks,
> Simcha
>
>No, it seems fairly consistent with my experience with Neurontin. It does seem to make my throat kind of parched and dry as well from what I remember, especially in the winter. I had a good synergy between Neurontin and Celexa, also Neurontin and Adderall worked fairly well during one depressive episode. I just get this weirdo side effect from taking Neurontin (thumping in my ears-eustachian tube, and a spasm in my chest wall, kind of like costochondritis). It really pisses me off because I really *liked* the stuff (and I didn't have to take much either 300mg 2x daily was PLENTY). The best I have ever felt was when I was taking a combo of Depakote+Neurontin+Celexa+Klonopin. I'm hoping that if and when Pregabalin comes out (a refined version of Neurontin), maybe I won't get those sfx from it. Neurontin works good for sleep, social anxiety/panic, it quieted my head out quite well. It seems to be a decent "augmentor" for a variety of anxiety/sleep/depression issues. There is one thing I found with it though, it seems that the benefits were dose-limited and increasing the dose past a certain point didn't seem to bring any further benefits. For me 900-1200mg/day was that threshold. I am med-sensitive so that might explain it.---Mitch
Posted by Simcha on November 17, 2002, at 22:58:39
In reply to Re: Neurontin -- titrate to 400mg down to .25mg Kl » Simcha, posted by Ritch on November 16, 2002, at 17:10:46
Mitch
Now I'm on 500mg for the second night in a row. So far so good. I'm still on .25mg Klonopin so I'm not sure if the Neurontin will be good for the Bruxism by itself yet.
Neurontin has added some brightness to my mood though. I like my experience on it so far. I'm titrating very slowly here.
I'm calling the pdoc tomorrow morning to report in.
Take Care,
Simcha
> No, it seems fairly consistent with my experience with Neurontin. It does seem to make my throat kind of parched and dry as well from what I remember, especially in the winter. I had a good synergy between Neurontin and Celexa, also Neurontin and Adderall worked fairly well during one depressive episode. I just get this weirdo side effect from taking Neurontin (thumping in my ears-eustachian tube, and a spasm in my chest wall, kind of like costochondritis). It really pisses me off because I really *liked* the stuff (and I didn't have to take much either 300mg 2x daily was PLENTY). The best I have ever felt was when I was taking a combo of Depakote+Neurontin+Celexa+Klonopin. I'm hoping that if and when Pregabalin comes out (a refined version of Neurontin), maybe I won't get those sfx from it. Neurontin works good for sleep, social anxiety/panic, it quieted my head out quite well. It seems to be a decent "augmentor" for a variety of anxiety/sleep/depression issues. There is one thing I found with it though, it seems that the benefits were dose-limited and increasing the dose past a certain point didn't seem to bring any further benefits. For me 900-1200mg/day was that threshold. I am med-sensitive so that might explain it.---Mitch
>
>
Posted by Dr. Bob on November 18, 2002, at 0:21:23
In reply to Re: Neurontin -- titrate to 400mg down to .25mg Kl » Ritch, posted by Simcha on November 16, 2002, at 11:52:47
> He gave me the book "Moodswing" to read so that I might evaluate my life to see if I identified with any of the cases in the book.
I'd just like to plug the new double double quotes feature:
http://www.dr-bob.org/babble/faq.html#amazon
But I don't mean to be pushy. Did you deliberately not use it to link to Amazon? If so, I'd be interested in why, over at PBA:
http://www.dr-bob.org/babble/admin/20020918/msgs/7717.html
Thanks!
Bob
Posted by Simcha on November 19, 2002, at 17:56:50
In reply to Re: double double quotes » Simcha, posted by Dr. Bob on November 18, 2002, at 0:21:23
Dr. Bob,
It simply slipped my mind. I was away when you originally added this feature therefore I'm not familiar with it. Do you get royalties or money when we use double double quotes?
Sorry to ruffle your feathers,
Simcha
Posted by Simcha on November 19, 2002, at 17:58:56
In reply to Re: double double quotes » Dr. Bob, posted by Simcha on November 19, 2002, at 17:56:50
I'm just testing this feature to see if it will work here. My medication change is still going well. I'm almost done with "Moodswing".
This is the end of the thread.
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