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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Danielle on May 17, 2000, at 23:03:05
Dh was released from the hospital this week. His medicines consist of:
Celexa 40mg morning
Buspar 10mg 3xday
Klonopin 2mg 2xday
Depakote 750mg at bedtimeWhen we had the prescription filled the pharmacist was concerned about taking that much Klonopin and Depokote at bedtime. Does it seem quite a bit? I had read the largest single dose of Depakote should be 250. His breathing seems so labored to me at night. Should we check with the doctor about dosage or does this seem right?
Thanks
Posted by bob on May 17, 2000, at 23:59:29
In reply to Med question Cam or anyone , posted by Danielle on May 17, 2000, at 23:03:05
A more important question may be whether you've ever noticed his breathing while asleep to be labored in the past, particularly with respect to snoring or actual stops in his breathing. A number of us here also have sleep apnea on our list of disorders. After having a sleep study done, I was rather shocked by the results. I mean, I knew I snored -- but I didn't realize that my oxygen level in my bloodstream (which should be up above 95%) was dropping to 68% while asleep. Can you imagine the trauma that getting 2/3's of the oxygen you need for 1/3 of your life can cause? Yikes!! Furthermore, I was showing some cardiac arhythmias, had at least one partial stoppage of breathing each minute, and actually stopped breathing completely for half a minute on one occasion.
You know, if you asked me to right now I wouldn NOT be able to hold my breath for 30 seconds voluntarily!
Anyway, I've have a CPAP (continuous positive air pressure) machine to help me breath at night for about five months now. Depression tends to be fairly common in people who have apnea, and treating the apnea MAY help partially or fully alleviate the depression (as it did for a colleague of my therapist's ... lucky b*st*rd!). My ENT specialist also is an expert on the apnea/depression link, so maybe he'll have something to contribute for me ... but I understand it can take some time to see any effects on behavior or mood.
Still, I'm sure my brain cells, individually at least, are much happier with the amount of oxygen they're getting every night nowadays.
cheers,
bob
Posted by Cam W. on May 18, 2000, at 2:20:06
In reply to Med question Cam or anyone , posted by Danielle on May 17, 2000, at 23:03:05
Danielle - I do not think that his med doasges of Klonopin or Depakote (damn Yankee names - but I am getting use to them), are out of line at all. It really depends on the disorder. I have seen much higher in some treatment resistant forms of bipolar disorder.Still, inform the doc of the labored breathing and inquire about the dosages. Did the pharmacist say why he thought the dosages were excessive? Was this his opinion or did his/her computer "beep" at him/her?
Hope this helps - Cam
Posted by Danielle on May 18, 2000, at 8:19:29
In reply to Re: Med question Cam or anyone , posted by Cam W. on May 18, 2000, at 2:20:06
Cam and bob,
Thanks for the quick responses. The pharmacist simply suggested they (the Yankee words) shouldn't be taken together, risk of too heavy sedation. I'm not sure why he is taking the Depakote, he (dh) blocked me from any info while in the hospital last time. He was mad he was there. He doesn't remember what their diagnosis was, previously it was GAD/depression. However, before hospitalization, his out patient doc suggested the heavy doses of Celexa may have unmasked some bi-polar. This is all driving me nuts.
As for the sleep apnea, I have noticed that in increasing amounts. He snores so loudly I cannot sleep. It appears as if his breathing is difficult and requires too much effort. Is this caused by the medicines?
Posted by Noa on May 18, 2000, at 17:25:38
In reply to Re: Med question Cam or anyone , posted by Danielle on May 18, 2000, at 8:19:29
Danielle, it can be exacerbated by medications that relax his muscle tone, yes, in the case of obstructive sleep apnea. I don't know if these meds are implicated in the rarer form of apnea--central sleep apnea, which is caused by the brain not reading the signals that the CO2 levels are high, which is the signal to take a breath. But for OSA, anything that causes the muscles around the airway (neck, etc.) to be more lax, could contribute. Here is a site to check out with more info:
http://www.sleepnet.com/apnea/apneainf.html
But I would definitely contact the doc to share your observation.
Posted by bob on May 19, 2000, at 0:03:12
In reply to Re: Med question Cam or anyone , posted by Noa on May 18, 2000, at 17:25:38
When I was on a neuroleptic (perphenazine), even a slight dose "relaxed" me so much that my always bad snoring took on some "Grand Central Station at the height of rush hour" proportions. Weight's another factor for OSA. Has he put on any extra pounds lately? Is he overweight in the first place?
If he can sleep on his side, that may keep his airway open enough for both of you to get some good rest ... but like Noa said, make sure you share this with your doctor.
cheers,
bob
This is the end of the thread.
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