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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by b2chica on March 7, 2014, at 13:12:56
Hi All..
i've been a little sporatic with my posting, and not always following up.
So for the last three weeks i've been fighting dangerously high anxiety. i say dangerous since as my old pdoc found out, if we get to it right away its fine, if we don't tend to it immediately i end up with either some kind of psychotic depression or a mixed episode (which is definitely where i've been at the last two days.My go to med in this case has always been zyprexa. well since i ended up in hospital last night i got an idea that i ll tell next post.
so let me review.***TRIGGER***
So last friday i went into a fit in the evening so bad that i wanted to not just kill myself but violently mutilate myself in the process...
i knew i couldn't act so instead i took a non-safe amount and mixture of medication, not to kill but to basically silence myself and my head. i was lucky that i didn't harm myself in the process, but was not exactly in a good state of mind .anyway, haloperidol was one of the meds. so monday i reported to new pdoc that i had tried haldol for 3-4 but had to stop due to SE
Tuesday saw T, and she saw me in a state she's not used to. very high agitation/anger/physical and mental state altered. she has been trying to contact my pdoc to no avail.
After that i took my med list (of what i've been on) i also notified staff i NEED INTERVENTION asap.
i had been requesting ativan at min..**********
Wednesday pdoc finally called back and said to do .5 haldol... this sent me into a rage that i could not control... i left work. and was screaming in my car and continued to be obsessive on WHY she would rx haldol when Just the previous week i tried it and it didn't do anything. at this point i was not homicidal or suicidal. but was Very F-ing angry!! i went to church for ash wed and all i could do was think angry thoughts and as of two days previous was starting to get visual illusions about death, dying, violent ways and those were intruding. so i left and went downstairs and called T, left voice message. ended up verbally abuse her voice mail (which i txt'd her and told her that)...she was fine with that.
feeling HORRIBLE and just trudged on with gabapentin, haldol and hydroxozine hcl. until i went to sleep (which was about 12:30 -ishYESTERDAY
so first thing in the morning once again the anxiety started BEFORE i even took my adderall (which pdoc doesn't seem to understand) but i digress. Luckily i had another appt with T. i was in a bad state when i got to her.
after talking she really wanted me to do hospital. if not for kiddos i would have. so she suggested something and i let her check into it.
she called the hospital, asked if a person with extreme anxiety, agitation that was not homicidal nor suicidal could come in to get the physiology under control without staying overnight.
The response was yes. i got the triage's nurses' name and went.*************************
GOOD IDEA
Long story short..
So i got to ER, was admitted Finally and about hour later they gave me 5mg zyprexa, 1mg ativan. that didn't work, hour later they gave me 50mg hydrazine HCL (like i've been on) and yes, still like placebo.
an hour later they gave me shot. Finally about 30-60min later hour better.
my body Finally slowed down (by this point i was exhausted), and got a little loopy but i wanted to leave. so after i showed that i ws better, i left.**********************
So this Gave me a Great idea this morning of what to try next....
ill explain what in a separate post ...Thank you for reading this...
b2c.
Posted by SLS on March 7, 2014, at 13:53:39
In reply to Bad Experiencing anxiety/mixed episode., posted by b2chica on March 7, 2014, at 13:12:56
I will be interested to read your next post.
Have you ever tried Tegretol or Trileptal? Depakote?
- Scott
Posted by tony p on March 7, 2014, at 21:18:22
In reply to Re: Bad Experiencing anxiety/mixed episode. » b2chica, posted by SLS on March 7, 2014, at 13:53:39
I can empathize. Mixed episodes can be hell. Somewhere deep in the babble archives is a night I got a Serotonin Syndrome reaction (very similar experience) from mixed meds and just posted all night until I calmed down.
Benzos work well to bring me down, but it takes A LOT, which is hard to get by a doc these days. 1mg Ativan is totally inadequate in my experience for a severe episode such as you're describing - something more like 2mg+ Clonazepam might work. Seroquel/quetiapine also works for me, but I'm not on any other neuroleptics as you evidently are.
Good luck & keep us posted.
Posted by phidippus on March 9, 2014, at 20:40:52
In reply to Bad Experiencing anxiety/mixed episode., posted by b2chica on March 7, 2014, at 13:12:56
What mood stabilizer are you on?
Eric
Posted by b2chica on March 10, 2014, at 12:27:51
In reply to Re: Bad Experiencing anxiety/mixed episode. » b2chica, posted by phidippus on March 9, 2014, at 20:40:52
i would probably say that the gabapentin is the mood stabilizer.
ive not responded well to most "mood stabilizers", tried:
topamax
triliptal
lamictalall seemed to Increase (or create) a cycling effect, not to mention triliptal almost gave me a stroke.
let me know what you think Eric. if you want i'll post what i've all been on... i can't even remember without looking at my list.
i see proc today.
b2c
Posted by phidippus on March 10, 2014, at 14:57:16
In reply to Re: Bad Experiencing anxiety/mixed episode., posted by b2chica on March 10, 2014, at 12:27:51
>i would probably say that the gabapentin is the mood stabilizer.
You'd need to be taking 2400 mg of Gabapentin for it to act as a mood stabilizer.
You have something against Lithium, right?
How about Tegretol?
Eric
Posted by b2chica on March 10, 2014, at 16:34:57
In reply to Re: Bad Experiencing anxiety/mixed episode. » b2chica, posted by phidippus on March 10, 2014, at 14:57:16
i was actually taking 2100mg most of last year. with this new pdoc she took it down to 900mg. which i told her today is kinda moot.
but at least she was able to see me ON zyprexa 5mg, 900mg gabapentin, adderlll and pristine 100mg, and hyroxizine 50mg.... with not great effect.
she took off the zyprexa and added saphris.
insurance only sort of covered it.. it (of course) wasn't a 'preferred' brand so i paid out 52.00 (! i just got three 5mg zyprexa tabs for the same price).... . at least i got 30 this time.yes issue with lithium.
no, i don't think i've tried tegretol, but like i said, most of the 'mood stabilizers i've been on actually made me have cycling of mood. which i don't normally have (at least at that rate).**********************
Eric, i took zyprexa last night (5mg) you think it would be ok to start saphrix tonight? i think my pdoc said yes, but my mind was kinda crazy at the time and don't remember a whole lot.
i called the office and left message, i never heard back.pharmacist said it would be ok... but i had a terrible experience once switching meds that i'm scared to death to be alone when i'm on it.
b2c
Posted by b2chica on March 10, 2014, at 16:37:35
In reply to Re: Bad Experiencing anxiety/mixed episode. » phidippus, posted by b2chica on March 10, 2014, at 16:34:57
Nevermind Eric, i saw post below... Thanks.
b2c
> i was actually taking 2100mg most of last year. with this new pdoc she took it down to 900mg. which i told her today is kinda moot.
>
> but at least she was able to see me ON zyprexa 5mg, 900mg gabapentin, adderlll and pristine 100mg, and hyroxizine 50mg.... with not great effect.
>
> she took off the zyprexa and added saphris.
> insurance only sort of covered it.. it (of course) wasn't a 'preferred' brand so i paid out 52.00 (! i just got three 5mg zyprexa tabs for the same price).... . at least i got 30 this time.
>
> yes issue with lithium.
> no, i don't think i've tried tegretol, but like i said, most of the 'mood stabilizers i've been on actually made me have cycling of mood. which i don't normally have (at least at that rate).
>
> **********************
>
> Eric, i took zyprexa last night (5mg) you think it would be ok to start saphrix tonight? i think my pdoc said yes, but my mind was kinda crazy at the time and don't remember a whole lot.
> i called the office and left message, i never heard back.
>
> pharmacist said it would be ok... but i had a terrible experience once switching meds that i'm scared to death to be alone when i'm on it.
>
> b2c
>
>
>
>
>
>
>
Posted by phidippus on March 10, 2014, at 16:41:07
In reply to Re: Bad Experiencing anxiety/mixed episode. » phidippus, posted by b2chica on March 10, 2014, at 16:34:57
i took zyprexa last night (5mg) you think it would be ok to start saphrix tonight?
Yes. You could even mix the two if you really felt like it. I'm currently mixing Invega and Geodon.
What's the dose of Saphris?
>i'm scared to death to be alone when i'm on it.
You can always call me 720-273-7293
Eric
Posted by b2chica on March 11, 2014, at 16:58:29
In reply to Re: Bad Experiencing anxiety/mixed episode., posted by phidippus on March 10, 2014, at 16:41:07
if ok. gonna txt u tnight.
I'm feeling rather uneasy...
Posted by phidippus on March 12, 2014, at 16:32:11
In reply to Re: Bad Experiencing anxiety/mixed episode., posted by b2chica on March 11, 2014, at 16:58:29
Text away!
Eric
Posted by Bissie66 on May 5, 2014, at 12:24:39
In reply to Re: Bad Experiencing anxiety/mixed episode. » b2chica, posted by phidippus on March 12, 2014, at 16:32:11
i'm having bad mixed episode too, for days now. it's the craziest i've ever felt except on some illegal drugs.
i'm in touch with and working with pdoc i trust him; he's good. he gave me his cell phone to call him over weekend if needed. i should have.
i have a cache of valium and klonopin, and a small amount (with a refill) of ativan. any sense on which is best and at what dose to STOP this temporarily. my doc said 2 mg klonopin at night, not that that's enough to put me to sleep at this point. also losing weight no appetite. i want to know what benzo i should take to get through work, home without hitting someone or screaming at someone. sometimes i have unusual reactions to things - like Neourontin made me CRAZY. sometimes i think but not sure that benzoa can add to this feeling of internal pressure like i want to explode. i normally write well and spell well. i can't right now.
Posted by phidippus on May 5, 2014, at 13:15:28
In reply to Re: Bad Experiencing anxiety/mixed episode., posted by Bissie66 on May 5, 2014, at 12:24:39
First off, benzos aren't going to provide much relief at this point.
What mood stabilizer are you on?
What's going to be most helpful is an antipsychotic, such as Zyprexa. If you don't have any, get a prescription ASAP or visit the emergency room where they can give you some.
Eric
Posted by Bissie66 on May 5, 2014, at 14:06:06
In reply to Re: Bad Experiencing anxiety/mixed episode. » Bissie66, posted by phidippus on May 5, 2014, at 13:15:28
thank you very much for your concern. i keep thinking the benzos will chill me out but they don't. (i do think they help some though. i'm keeping it together at work bc of valium i think.)
i am on lithium 600 mg (just increased from 300) and lamictal 200 mg. i am on risperdal 1 mg which is an antypsychotic -- why isn't it working?
i'm also on wellbutrin 450 mg. normally i'm much more likely to have a depressed episode but that is NOT what this is. i almost miss being depressed when i could enjoy lying around all night just watching tv and going to sleep early.
have i mentioned i've lost 6 pounds in a week? on Risperdal?? Bizarre.
> First off, benzos aren't going to provide much relief at this point.
>
> What mood stabilizer are you on?
>
> What's going to be most helpful is an antipsychotic, such as Zyprexa. If you don't have any, get a prescription ASAP or visit the emergency room where they can give you some.
>
> Eric
Posted by phidippus on May 5, 2014, at 14:40:29
In reply to Re: Bad Experiencing anxiety/mixed episode. » phidippus, posted by Bissie66 on May 5, 2014, at 14:06:06
If raising the Risperdal doesn't help, a change to another antipsychotic may be warranted.
I would try to get up to 900 on the Lithium if you can tolerate it.
I'm honestly surprised you're having breakthrough symptoms being on both the lithium and the lamictal, but both are in the low dose range.
The one thing that may be contributing to your mixed symptoms is the Wellbutrin - that's a very high dose. Can you stop this for a while and see what happens?
Eric
Posted by bissie66 on May 6, 2014, at 15:45:24
In reply to Re: Bad Experiencing anxiety/mixed episode. » Bissie66, posted by phidippus on May 5, 2014, at 14:40:29
Eric, I don't know who you are or if your're a doc but it's amazing bc my pdoc just told me 1) raise lithium to 900 mg 2) raise risperdal to 2 mg) and 3) lower wellbutrin to 150 mg. all things you suggested! thank you!
If raising the Risperdal doesn't help, a change to another antipsychotic may be warranted.
>
> I would try to get up to 900 on the Lithium if you can tolerate it.
>
> I'm honestly surprised you're having breakthrough symptoms being on both the lithium and the lamictal, but both are in the low dose range.
>
> The one thing that may be contributing to your mixed symptoms is the Wellbutrin - that's a very high dose. Can you stop this for a while and see what happens?
>
> Eric
>
>
>
>
Posted by phidippus on May 6, 2014, at 16:27:23
In reply to Re: Bad Experiencing anxiety/mixed episode. » phidippus, posted by bissie66 on May 6, 2014, at 15:45:24
I'm glad your pdoc made those changes and I hope you start feeling better soon.
Eric
This is the end of the thread.
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