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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by corafree on March 10, 2005, at 9:13:28
Was hyperventilating w/ panic until top of head felt as if would blow off; severe, unimagineable, frightening nervous breakdown.
Went to hospital where ALL MEDS meds were changed as follows:
From Xanax cross tapered; to VALIUM. From trazodone for sleep and Eff-XR; to SEROQUEL 300mg for sleep & 25mg prn anxiety, and TRILEPTAL 300mg 2X a day.
All these new meds begun approx. 5 days ago.
I am anxiety/panic/hyperventilating free. But, I am a relaxed ZOMBIE!
I have appts to attend to and no way to get there on my own. Don't believe I can drive my car. Don't believe could walk very far. Not quick enough on the mindset to bus. I do live alone on a low income.
Never had auditory or visual hallucinations Never had a seizure, that I know of, and do not have epilepsy. My dx is borderline. I realize the similarity between borderline dx and hypomanic dx.
I don't know what to do. My P wants me to tell him what I want to do, and never having been in this 'zombie' (yet no panic/anxiety) state, I cannot tell him what med I do or do not want.
I have appts at 11a and 3p AZ time today.
Can anyone SHARE PLS; nowhere else to turn.
tks cf
Posted by med_empowered on March 10, 2005, at 10:31:43
In reply to Seroquel-Trileptal-Valium Combo??!!, posted by corafree on March 10, 2005, at 9:13:28
hey! If you're feeling like a zombie, tell your doc that. No one should feel completely numbed out. What may work is reducing your Seroquel until you feel better or until you're completely off of it. Using a straight up sleeping pill at nite (as opposed to trazodone, which has antidepressant action) might be a good idea...obviously, there's ambien; there's also halcion, restoril, chloral hydrate, and dalmane.
Posted by ed_uk on March 10, 2005, at 10:34:17
In reply to Re: Seroquel-Trileptal-Valium Combo??!!, posted by med_empowered on March 10, 2005, at 10:31:43
Hi cf,
I'm sorry to hear you've been having such a rough time.
>What may work is reducing your Seroquel until you feel better.
I agree with med, I think this is a good idea.
Best of luck,
Ed.
Posted by Ritch on March 10, 2005, at 10:40:34
In reply to Seroquel-Trileptal-Valium Combo??!!, posted by corafree on March 10, 2005, at 9:13:28
> Was hyperventilating w/ panic until top of head felt as if would blow off; severe, unimagineable, frightening nervous breakdown.
>
> Went to hospital where ALL MEDS meds were changed as follows:
>
> From Xanax cross tapered; to VALIUM. From trazodone for sleep and Eff-XR; to SEROQUEL 300mg for sleep & 25mg prn anxiety, and TRILEPTAL 300mg 2X a day.
>
> All these new meds begun approx. 5 days ago.
>
> I am anxiety/panic/hyperventilating free. But, I am a relaxed ZOMBIE!
>
> I have appts to attend to and no way to get there on my own. Don't believe I can drive my car. Don't believe could walk very far. Not quick enough on the mindset to bus. I do live alone on a low income.
>
> Never had auditory or visual hallucinations Never had a seizure, that I know of, and do not have epilepsy. My dx is borderline. I realize the similarity between borderline dx and hypomanic dx.
>
> I don't know what to do. My P wants me to tell him what I want to do, and never having been in this 'zombie' (yet no panic/anxiety) state, I cannot tell him what med I do or do not want.
>
> I have appts at 11a and 3p AZ time today.
>
> Can anyone SHARE PLS; nowhere else to turn.
>
> tks cf
Wow, it kind of sounds like they *might* be treating the traz/Effexor discontinuation with Seroquel so you can sleep. The Xanax to Valium move was probably to get a more steady level of benzo in your system, not so peaky/crashing. The Trileptal add sounds like they *might* be rethinking your dx. The notable absence of any antidepressants suggest they may be reconsidering you as mixed bipolar. Borderline tends to do well with SSRI or other serotonergics. That's just what it looks like to me. Their next move may be to slowly bring down the Seroquel as your body gets used to no traz/Effex (ie). You aren't panicking, so that's a big plus. Maybe the zombie effects will diminish with time? 300mg is quite a dose (for me anyhow). My suggestion would be to ask them something like: "When can I get the Seroquel dosage down, because it's making me too much of a zombie? What's the PLAN here? Are you re-thinking my diagnosis?", that sort of stuff. That should help.
Posted by corafree on March 10, 2005, at 11:08:04
In reply to Re: Seroquel-Trileptal-Valium Combo??!! » corafree, posted by Ritch on March 10, 2005, at 10:40:34
I perceive you mean Trileptal is for hypomanic and not for borderline?
I have only racing thoughts sometimes, usually always associated w/ anxiety. When not anxious my thoughts are smooth and clear.
On this basis can they have dx'd me bipolar I wonder.
No other symptoms of bipolar.
I will ask P re: bringing Seroquel down eventually. I will ask if they are reconsidering my diagnosis.
Why Trileptal prescribed? They did not explain.
They want me on both of these DURING THE DAY!
Getting ready to go to my P.
Did I tell you my daughter went w/ me last time to see him, and he thought my daughter was the patient. Yep, he looked at her, not me, and said 'so, how are you doing?' Some P huh??????
tks cf
Posted by Ritch on March 10, 2005, at 12:57:15
In reply to Re: Seroquel-Trileptal-Valium Combo??!!, posted by corafree on March 10, 2005, at 11:08:04
> I perceive you mean Trileptal is for hypomanic and not for borderline?
>
> I have only racing thoughts sometimes, usually always associated w/ anxiety. When not anxious my thoughts are smooth and clear.
>
> On this basis can they have dx'd me bipolar I wonder.
>
> No other symptoms of bipolar.
>
> I will ask P re: bringing Seroquel down eventually. I will ask if they are reconsidering my diagnosis.
>
> Why Trileptal prescribed? They did not explain.
>
> They want me on both of these DURING THE DAY!
>
> Getting ready to go to my P.
>
> Did I tell you my daughter went w/ me last time to see him, and he thought my daughter was the patient. Yep, he looked at her, not me, and said 'so, how are you doing?' Some P huh??????
>
> tks cf
>
>Racing thoughts with anxiety.. I've got rapid-cycling bipolar and in *all* my "up" phases (whether they are mixed,etc.) the RACING THOUGHTS are *always* the *common* symptom. Sometimes it's racing thoughts with anxiety/panic without euphoria or anger, other times it's racing thoughts with bubbly euphoria w/o anger or anxiety, sometimes it's racing thoughts with temper w/o euphoria or anxiety, sometimes it's racing thoughts w/o euphoria, anxiety, OR anger, and I just can't get it together and focus on anything -- a classic ADHD like thing. Let us know what they say..
Posted by B2chica on March 10, 2005, at 13:11:39
In reply to Re: Seroquel-Trileptal-Valium Combo??!!, posted by corafree on March 10, 2005, at 11:08:04
CF
those that specialize in BPD definatley recommend people be put on a moodstabilizer...trileptal is a good one.
i have BP2 and some traits of BPD, was on Trileptal for a while it worked great for me. however the side effects you are experiencing 'gotta su*k'- but it does take a couple weeks before SE go away and you can tell if meds are working for you.
i remember you were very recently suicidal, hopefully they have you on MS and AD.
-the important question here is do you trust your pdoc? sounds like you need to ask him lots of questions...if your pdoc gets defensive about the meds your on it's time to find a new doc. he/she should explain why their putting you on what meds and what they do.
my pdoc before he starts me on a new med tells me why he's switching, what the drug does and the effects he hopes to see...i ask TONS of questions and he's great about it...you deserve the same.
B2c.
> I perceive you mean Trileptal is for hypomanic and not for borderline?
>
> I have only racing thoughts sometimes, usually always associated w/ anxiety. When not anxious my thoughts are smooth and clear.
>
> On this basis can they have dx'd me bipolar I wonder.
>
> No other symptoms of bipolar.
>
> I will ask P re: bringing Seroquel down eventually. I will ask if they are reconsidering my diagnosis.
>
> Why Trileptal prescribed? They did not explain.
>
> They want me on both of these DURING THE DAY!
>
> Getting ready to go to my P.
>
> Did I tell you my daughter went w/ me last time to see him, and he thought my daughter was the patient. Yep, he looked at her, not me, and said 'so, how are you doing?' Some P huh??????
>
> tks cf
>
>
Posted by corafree on March 10, 2005, at 13:37:14
In reply to Re: Seroquel-Trileptal-Valium Combo??!!, posted by B2chica on March 10, 2005, at 13:11:39
Back from P.
He was almost upset, and definitely confused at the mood stabilizers.He cut back Seroquel 300mg to 100mg and added back trazodone 100mg; together for sleep.
He said, "I don't know why they're giving you Seroquel, especially daytime Seroquel, and, as far as Trileptal goes, you can take it or not, I don't care, I don't know why they think you need it. You are borderline, right? I don't see you as bipolar."
Well guys ... I'm on my own here. What a mess!
This is MY plan:
sleep 100mg Seroquel & 100mg trazodone
daytime Seroquel - 25mg only midday naptime
daytime Trileptal - give it a shot @ 3x a day
daytime Valium - 3x a day
Does this sound o.k.? (I'm asking myself this question also??!!)
Hmmm, yes, I desperately need a new P, but am too 'numb' to make necessary phone calls and arrangements at this time.
tks cf
Posted by corafree on March 10, 2005, at 13:51:39
In reply to Re: Seroquel-Trileptal-Valium Combo??!! » corafree, posted by Ritch on March 10, 2005, at 12:57:15
Racing thoughts with anxiety.. I've got rapid-cycling bipolar and in *all* my "up" phases (whether they are mixed,etc.) the RACING THOUGHTS are *always* the *common* symptom. Sometimes it's racing thoughts with anxiety/panic without euphoria or anger, other times it's racing thoughts with bubbly euphoria w/o anger or anxiety, sometimes it's racing thoughts with temper w/o euphoria or anxiety, sometimes it's racing thoughts w/o euphoria, anxiety, OR anger, and I just can't get it together and focus on anything -- a classic ADHD like thing. Let us know what they say.
I don't know what rapid cycling means?
The P said if I don't see or hear things that aren't there, I'm not bipolar.
I've spoken to him re: ADD and he has said 'no' I don't have it unless someone in my family had it.
Did you see what I just posted before I read yours? It will be an AD and an MS. Does that sound like it will help me, the way I'VE decided to take these meds, in this med-war between P in hospital and P outside.
I have always wondered, said before, some racing thoughts, difficulty catching onto things quick ... ADD or bipolar?! I give up.
If any of you all think MY way of taking these new meds and the old trazodone is incorrect, pls let me know. thanks a lot!!! cf
Posted by corafree on March 10, 2005, at 14:11:39
In reply to Re: Seroquel-Trileptal-Valium Combo??!!, posted by corafree on March 10, 2005, at 13:37:14
CORRECTION (Error re: Trileptal)
This is MY plan:
sleep 100mg Seroquel & 100mg trazodone
daytime Seroquel - 25mg only midday naptime
daytime Trileptal - 300mg 2x a day (morn & eve?)
daytime Valium - 1mg 3x a day
cf
Posted by ed_uk on March 10, 2005, at 14:46:27
In reply to Re: Seroquel-Trazodone-Trileptal-Valium Combo??!!, posted by corafree on March 10, 2005, at 14:11:39
Hi cf!
Can you describe your racing thoughts?
Ed.
Posted by corafree on March 10, 2005, at 16:53:12
In reply to Re: Seroquel-Trileptal-Valium Combo??!!, posted by med_empowered on March 10, 2005, at 10:31:43
Med-empowered
I asked for a sleeping pill from the list you provided. He said, flat out, no. Yet, he did add back the Trazodone, which is, he said, NOT A VERY STRONG ANTI-DEPRESSANT.
Just wanted to let ya' know I tried. cf
Posted by corafree on March 10, 2005, at 17:44:10
In reply to Re: Seroquel-Trazodone-Trileptal-Valium Combo??!! » corafree, posted by ed_uk on March 10, 2005, at 14:46:27
Ed, I'll have to answer that question as I examine and can give you a correct answer.
The first thing I think of is having an idea or plan, then losing it as my mind has moved on to some other thought. Often, I never recall the original idea/plan.
Of course, there is the complete forgetfullness of, say, directions. I listen carefully and then, blank, they're gone.
I am thinking of a certain subject, even when praying, and before I know it, something totally different is in my thinking. When praying, I'll say, sorry God, lost my train of thought, now back to my prayer.
I know it's hard to be clear about how one feels.
If I think of other ways to describe, will respond again.
tks ... cf
Posted by corafree on March 10, 2005, at 17:50:36
In reply to Re: Seroquel-Trileptal-Valium Combo??!!, posted by B2chica on March 10, 2005, at 13:11:39
So you have borderline and hypo(low) bipolar? cf
Posted by tygereyes on March 10, 2005, at 20:47:38
In reply to Re: Seroquel-Trazodone-Trileptal-Valium Combo??!!, posted by corafree on March 10, 2005, at 14:11:39
I'm borderline and I take Seroquel (25 mgs) and Trileptal (600 mgs) plus Desipramine (75 mgs). NOTHING has helped my borderline symptoms like Trileptal has, and Seroquel provides an additive effect PLUS helps with my chronic insomnia.
Posted by Phillipa on March 10, 2005, at 21:12:52
In reply to Re: Seroquel-Trazodone-Trileptal-Valium Combo??!!, posted by tygereyes on March 10, 2005, at 20:47:38
Corafree, You're only taking lmg of Valium? I would think 5mg at the very least 3x day. I believe this would eliminate the need for seroquel, as it has a relaxing effect, and a long half-life. It builds up in your system. Seroquel knocked me out and left me drunk. As I said before I tried a low dose of trileptal and was told it was for mood, and to help with sleep No side effects at l50mg. Fondly, Phillipa
Posted by corafree on March 11, 2005, at 0:53:31
In reply to Re: Seroquel-Trazodone-Trileptal-Valium Combo??!!, posted by Phillipa on March 10, 2005, at 21:12:52
Phillipa and all:
You found another error Phillipa. No, do not take 1mg Valium; take 10mg; sorry.
So, made corrections and this IS my plan for now:
1) Seroquel 100mg for sleep2) trazodone 100mg for sleep
3) Seroquel 25mg, x3 only, for day panic/anxiety
3) Trileptal 300mg 2x a day
I like your responses re: Trileptal and want to continue giving it a try, as even this evening I am feeling relaxed and comfortable, and it's been a long time since I've felt anything like this!!!
My regular P was lackadaisical about Trileptal altogether. The P I had in the hospital kept saying he thought I needed it, and I'm beginning to think he was right.
Not sure what 'times of day' to take these two doses of Trileptal. Instructions on bottle are every 12hrs.
Appreciate suggestions or your experience w/ Trileptal as far as dosage and regimen. Will also check Internet.
After all these years of not feeling I have enough symptoms of bipolar to necessitate a mood stabilizer, and not knowing that people w/ borderline take mood stabilizers, I am finally seeing my illness and treatment more clearly. I think may have BPD and type 2(?-hypo) bipolar.
Hate ask you all again, but do you think I'm onto something here?
Don't worry, I realize what you may say may be your opinion or your experience, and would never hold anyone here responsible to my decisions or actions! It's just current P, as I told you, is not helping me. Remember when I said he thought my daughter was his patient as she accompanied me to last appt.? I forgot to mention, she has short blonde hair, and I have very long dark hair!
I feel this combo is pretty sedating, but maybe that will lessen w/ time; better than the awful nervous system overload I experienced.
goodnight all, cf
Posted by Ritch on March 11, 2005, at 10:21:03
In reply to Re: Seroquel-Trileptal-Valium Combo??!! » Ritch, posted by corafree on March 10, 2005, at 13:51:39
> Racing thoughts with anxiety.. I've got rapid-cycling bipolar and in *all* my "up" phases (whether they are mixed,etc.) the RACING THOUGHTS are *always* the *common* symptom. Sometimes it's racing thoughts with anxiety/panic without euphoria or anger, other times it's racing thoughts with bubbly euphoria w/o anger or anxiety, sometimes it's racing thoughts with temper w/o euphoria or anxiety, sometimes it's racing thoughts w/o euphoria, anxiety, OR anger, and I just can't get it together and focus on anything -- a classic ADHD like thing. Let us know what they say.
>
> I don't know what rapid cycling means?
>
> The P said if I don't see or hear things that aren't there, I'm not bipolar.
>
> I've spoken to him re: ADD and he has said 'no' I don't have it unless someone in my family had it.
>
> Did you see what I just posted before I read yours? It will be an AD and an MS. Does that sound like it will help me, the way I'VE decided to take these meds, in this med-war between P in hospital and P outside.
>
> I have always wondered, said before, some racing thoughts, difficulty catching onto things quick ... ADD or bipolar?! I give up.
>
> If any of you all think MY way of taking these new meds and the old trazodone is incorrect, pls let me know. thanks a lot!!! cfYes, I read your prev. post and it seems strange that "they" were not communicating with your current pdoc. I guess that probably happens quite a bit. It seems like he understands your situation and made some reasonable changes. Hope it works out OK. My bipolar is milder it is BP-II. I don't get psychotic. My mood changes fairly regularly over 3 week periods and repeats again.
Posted by corafree on March 11, 2005, at 14:03:40
In reply to Re: Seroquel-Trileptal-Valium Combo??!! » corafree, posted by Ritch on March 11, 2005, at 10:21:03
My major prob' is anxiety. I think depression followed anxiety. I don't have any psychoses. I don't have regular (like you say, three week intervals) ups and downs. I have no manic states.
Usually downs are related to something that has happened in my life.
The only thing that I have is 'sometimes' racing thoughts, and problems with study/learn/recall.
P in hospital prescribed Seroquel 300mg h.s. & 25mg 3x a day, and Trileptal 300mg 2x a day.
My P (outside of hospital) asked how I was and I said well I feel like a 'zombie'. He cut my sleep Seroquel from 300mg to 100mg, mix w/ 100mg trazodone (Desyrel).
The P in hospital had discontinued trazodone.
This morning I awakened, recalling persecution nightmare, and felt a fullness feeling in my head.
Too bad I couldn't stay off trazodone, as have had these nightmares for a few years while on it.
It does seem like the Seroquel is calming my mood w/ the 25mg 3x a day.
My hospital treatment wasn't good. Thank God I got out of there. Only thing that was good was learning that borderlines take mood stabilizers.
I wonder why my P outside the hospital never prescribed any mood stabilizers??
I'll stop wondering and find a new doc when can gather myself together again. Until then, will try my best to take care of myself, as I don't feel there is any professional person out there taking care of me. cf
Posted by B2chica on March 11, 2005, at 14:07:42
In reply to Re: Seroquel-Trileptal-Valium Combo??!! » B2chica, posted by corafree on March 10, 2005, at 17:50:36
among others...yes, gee lets see the list:
BP2, BPD(depressive type), dysthymia, PTSD, ED, ADD. have all been tossed around at one time or another...i think this last stay at the hospital some nurses were convinced i was shizophrenic..they constantly asked if i was hearing voices...no (though i didn't mention to them i do hear chatter or music at nights sometimes...it's usually when i'm tired and i think it has more to do with overstimulation and a sleep issue. cuz i have lots of sleep trouble.> So you have borderline and hypo(low) bipolar? cf
Posted by corafree on March 11, 2005, at 14:19:35
In reply to Re: Seroquel-Trileptal-Valium Combo??!! » corafree, posted by B2chica on March 11, 2005, at 14:07:42
Yep, I think lack of sleep can cause all sorts of changes in sound, hearing, your voice, others' voices, etc. cf
Posted by Phillipa on March 11, 2005, at 15:35:26
In reply to Re: Seroquel-Trileptal-Valium Combo??!! » B2chica, posted by corafree on March 11, 2005, at 14:19:35
Corafree, I'm glad you're feeling better. Did you discontinue the valium altogether? It would be best to drop down by 5mg at a time. It's not a hard drug to stop taking due to its long half-life. You do need to taper though, especially if it's taking the place of klonopin. Valium will make you feel very relaxed. My anxiety is my prodominant symptom too. If it's controlled, I don't think I'm depressed. Fondly, Phillipa
Posted by corafree on March 11, 2005, at 18:36:09
In reply to Re: Seroquel-Trileptal-Valium Combo??!!, posted by Phillipa on March 11, 2005, at 15:35:26
I discontinued klonopin w/o a taper to Xanax, and that was prob' one reason for the horrible, unimagineable nervous system breakdown.I am currently taking the Valium x3 a day. Yes, it does have a long life, so should keep me steady enough to pull my life back together somehow.
My only support is out of town this weekend.
I gave my boyfriend his freedom in Jan. as I believed we were like two magnets, couldn't stay away from each other; but when together we had too much past damage to move forward.
I suppose I am not only grieving my father, but also the end of this 10yr (crutch) relationship. I need meds for anxiety more than ever.
But, I am glad I take no more Eff-XR. Only side effect from discontinuing seems to be feeling hot and sweaty, and maybe altered sleep.
Want to ditch the trazodone (Desyrel) also. That would be the last of anti-depressants.
It's awful to think that all this time, all these years, what I needed wasn't an anti-depressant, but was a mood stabilizer!
tks Phillip, cf
Posted by Phillipa on March 11, 2005, at 19:01:04
In reply to Re: Seroquel-Desyrel-Trileptal-Valium » Phillipa, posted by corafree on March 11, 2005, at 18:36:09
Corafree, That really gives me something to think about. I don't want the AD's. I've always gotten the anxiety relief from benzos, so why the Ad's. Oh, I know, the drug companies said it eliminates anxiety! Anyway you're making me think about suggesting a mood stabalizer instead of the AD's. So, you think they're better and relieve anxiety best? Fondly, Phillipa
Posted by corafree on March 11, 2005, at 22:27:56
In reply to Re: Seroquel-Desyrel-Trileptal-Valium » corafree, posted by Phillipa on March 11, 2005, at 19:01:04
Well, yes, Phillipa. I had no idea this was what mood stabilizers did ... calm you this way. It feels like they're better than benzos. I had always thought they were for bipolar and since I wasn't bipolar, I never looked into them, and NO DOC EVER PRESCRIBED ONE! It was always ADs that didn't work! I just spoke to a friend who said I was on two much though. She said she never takes Seroquel during the day, but I'm prescribed 25mg 3x a day and then 100mg w/ trazodone (yuch - so tired of trazodone) for sleep. Also the Trileptal is a sort of mood stabilizer, but described as an anti-epileptic in PDR. My tremors have really lessened. The friend that I was speaking w/ is definitely bipolar, and she says that bipolar people should not take anti-depressants at all. This is really all new to me. cf
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Dr. Bob is Robert Hsiung, MD,
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