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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Phillipa on March 17, 2006, at 12:28:17
I've been taking l00mg of luvox at night and with that the pdoc raised valium to 20mg. I have been sleeping later and later now to 11:30am Even though I don't go to sleep till 2am I used to wakeup earlier and now he wants me to take another 50mg of luvox in the am. He says it will give me energy. But the luvox seems to make me tireder so what would you do? The drug info says luvox potentiate the effects of valium . I am very anxious so he thinks it's a good thing. But getting up this late makes me more nervous as the day is over.I'm confused? And he knows about the valium and luvox in combination. Thanks fondly, Phillipa
Posted by Racer on March 17, 2006, at 13:35:12
In reply to Why Would PDoc UP Luvox when Valium Potentiates it, posted by Phillipa on March 17, 2006, at 12:28:17
What would I do? I'd follow the doctor's instructions, and if I questioned what he recommended, I'd ask him why he was recommending it.
Beyond that, upping the Luvox, since it has improved your symptomsin the past, and since it may reduce anxiety, makes sense to me. It also makes sense, despite it making you a bit tired, to try it in the AM. Could be taking some in teh AM will improve that whole "sleeping until late" thing. I've often found that taking meds in teh AM, even if they make me sleepy, can help improve sleep at night.
Here's something that made me laugh, but is a really good thing to think about. You know what my doctor said was the first question to ask when someone complained of insomnia? "Are you in bed?" Apparently, for many people who complain of insomnia, the answer is no.
So, try following the rules of Good Sleep Hygiene. You've got nothing to lose, and it really can help mood to sleep more regularly and more regular hours. There really are biochemical changes in your body that make it better to sleep when it's dark, and wake when it's light.
Good luck.
Posted by Phillipa on March 17, 2006, at 13:48:06
In reply to Re: Why Would PDoc UP Luvox when Valium Potentiate, posted by Racer on March 17, 2006, at 13:35:12
Racer just so you know I really value your info. With all the problems going on in your own life you take the time to answer others. Thanks so much. I just find it hard to understand how something that makes you tired can give you more energy. And I do go to bed very late. Thanks again Racer you know I think I love you as a friend. Love Phillipa
Posted by yxibow on March 17, 2006, at 17:11:59
In reply to Why Would PDoc UP Luvox when Valium Potentiates it, posted by Phillipa on March 17, 2006, at 12:28:17
> I've been taking l00mg of luvox at night and with that the pdoc raised valium to 20mg. I have been sleeping later and later now to 11:30am Even though I don't go to sleep till 2am I used to wakeup earlier and now he wants me to take another 50mg of luvox in the am. He says it will give me energy. But the luvox seems to make me tireder so what would you do? The drug info says luvox potentiate the effects of valium . I am very anxious so he thinks it's a good thing. But getting up this late makes me more nervous as the day is over.I'm confused? And he knows about the valium and luvox in combination. Thanks fondly, Phillipa
At 150mg, it probably hasn't reached a clinically significant drug-drug interaction, however the P450 interaction can't be ignored. You are reporting something that is conceivably possible -- these things usually take a while to occur, over weeks of time, but you've been on the Luvox for a while. The only other agent that would be appropriate instead of Valium would be Ativan (and possibly the not very often used Serax) because that largely does not go through your liver system.Have you mentioned the drug-drug interaction at all in sessions ? I assume you have -- it seems that not every pdoc is aware of P450 interactions, this one at 3A4. Of course this particular one is based off of one study which would say it would about double the blood half-life, which doesnt mean necessarily that it would double it once it crossed the blood-brain barrier, but most likely by some degree.
Luvox is usually taken twice daily if I recall when I did, so adding more in the morning but keeping the bulk at night because its sedating, at least at first, is allright.
It's allright to mention these things to your doctor, either you or some company is paying him so its your time.
Tidings-- Jay
Posted by fairywings on March 17, 2006, at 20:20:02
In reply to Why Would PDoc UP Luvox when Valium Potentiates it, posted by Phillipa on March 17, 2006, at 12:28:17
Hi Phillipa,If you trust your pdoc, and your he's expressed that he's aware of the potentiation, I'd be okay with it. I do the same thing - go to bed too late, then it messes me up. Going to bed earlier, getting up earlier, and taking the meds earlier might be helpful.
Does your pdoc know you stay up till 2 AM? Just curious.
fw
Posted by Phillipa on March 17, 2006, at 20:41:13
In reply to Re: Why Would PDoc UP Luvox when Valium Potentiates it » Phillipa, posted by fairywings on March 17, 2006, at 20:20:02
Going to bed late is a sign of depression he says.but once before I took luvox up to 250mg and I felt much more energy but he was giving it to me with 5-6mg of ativan which is compatatible with luvox. That's why I don't know what to do. A different pdoc. Love Phillipa
Posted by fairywings on March 17, 2006, at 20:55:06
In reply to Re: Why Would PDoc UP Luvox when Valium Potentiates it » fairywings, posted by Phillipa on March 17, 2006, at 20:41:13
I guess so much depends on what's going on at the time. You know - things affect ppl diff. at diff. times, and when anxiety is high, or you're worried about the meds, that makes things worse, or makes them seem worse. It can be a vicious cycle. I know it's a new doc, do you have confidence in him? Have you told him about the Luvox/Ativan combo? What's his opinion?
Do you know why you stay up so late? Is it bec. you're not tired? What happens if you try to go to bed? Do you have sleep meds?
fw
Posted by yxibow on March 18, 2006, at 2:16:53
In reply to Re: Why Would PDoc UP Luvox when Valium Potentiates it » fairywings, posted by Phillipa on March 17, 2006, at 20:41:13
> Going to bed late is a sign of depression he says.but once before I took luvox up to 250mg and I felt much more energy but he was giving it to me with 5-6mg of ativan which is compatatible with luvox. That's why I don't know what to do. A different pdoc. Love Phillipa
Its a sign of depression, its possibly a sign of anxiety too. Its also a sign of lifelong insomnia, genetically induced. As I am pot calling the kettle black staying up even at the moment. I know with the extreme Seroquel load, that the hour at night that I take it and when I sleep changes how stupified and tired I am in the morning and a wide range of when that wears off.
Sometimes I think its a case of trying to stretch the candle at both ends, that saying good night early is a sign that you've resigned the day and there's one less day left. But that is sort of an equally irrational look at it, because one could have so much of the daytime available if one went to sleep earlier. I think it and insomnia even enters the fear of death and the unknown --
"To sleep, perchance to dream-
ay, there's the rub."-- Shakespeare
But back to your previous thought -- if you're not happy with your present pdoc, and he's not listening... as I've said... its your time, there are others out there somewhere. But I would try to stick with the current medical treatment at the moment at any rate, and try to convince him of what is going on. I think I babblemailed you about this.
Tidings
-- Jay
Posted by Phillipa on March 18, 2006, at 12:53:07
In reply to Re: Why Would PDoc UP Luvox when Valium Potentiate » Phillipa, posted by yxibow on March 18, 2006, at 2:16:53
Jay I think you E-mailed me could you reply a part of it I didn't understand.Thanks Phillipa
This is the end of the thread.
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