Psycho-Babble Medication Thread 101291

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Dr. Kramer : Any suggestions or advice - PLEASE

Posted by Optimistic on April 1, 2002, at 11:38:07

I have been having a terrible time each morning when I awaken at about 5 AM. Each day I get up very tired, trembling and shaking, and have severe nausea.This lasts all morning and then usually improves about 1 PM. This has been going on for months now.
The only meds I am taking are Remeron 7.5 mg at night and Klonopin .25 mg BID.
I have depression and anxiety. The reason the Remeron is so low is that at higher doses it really wasn't helping much but without any I have insomnia so I take it to help with sleeping. I have not had any luck with other AD's. Either it was too stimulating and anxiety producing or too sedating and totally numbed me.
Any thoughts as to why I awaken with these same symptoms every day and what can I do to avoid them?? Thank you for your help.

 

Re: Dr. Kramer : Any suggestions or advice - PLEASE » Optimistic

Posted by fachad on April 1, 2002, at 13:05:04

In reply to Dr. Kramer : Any suggestions or advice - PLEASE, posted by Optimistic on April 1, 2002, at 11:38:07

I don't know what Dr. Kramer will recommend, but I'll offer a suggestion .

Have you ever tried TCAs like Elavil or Doxepin or Pamelor?

My wife had terrible IBS, which is controlled by Elavil. One of her main symptoms was waking up with stomach pain, nausea, and vomiting.

Here's a post I put up about IBS and Elavil and her saga:

http://www.dr-bob.org/babble/20020322/msgs/99806.html

Sometimes even a very low dose such as 10mg or 25 mg of a TCA like Elavil can really help, and TCAs get forgotten because of all the glamorous new meds. For some people, they work wonders.


> I have been having a terrible time each morning when I awaken at about 5 AM. Each day I get up very tired, trembling and shaking, and have severe nausea.This lasts all morning and then usually improves about 1 PM. This has been going on for months now.
> The only meds I am taking are Remeron 7.5 mg at night and Klonopin .25 mg BID.
> I have depression and anxiety. The reason the Remeron is so low is that at higher doses it really wasn't helping much but without any I have insomnia so I take it to help with sleeping. I have not had any luck with other AD's. Either it was too stimulating and anxiety producing or too sedating and totally numbed me.
> Any thoughts as to why I awaken with these same symptoms every day and what can I do to avoid them?? Thank you for your help.

 

Re: Dr. Kramer : Any suggestions or advice - PLEASE » Optimistic

Posted by Bob on April 1, 2002, at 16:20:55

In reply to Dr. Kramer : Any suggestions or advice - PLEASE, posted by Optimistic on April 1, 2002, at 11:38:07

How long have you been at the .25mg Klonopin dose? Have you reduced it from a higher level within the last 6 months?

Bob

 

Re: Dr. Kramer : Any suggestions or advice - PLEASE

Posted by optimistic on April 1, 2002, at 17:24:09

In reply to Re: Dr. Kramer : Any suggestions or advice - PLEASE » Optimistic, posted by Bob on April 1, 2002, at 16:20:55

> How long have you been at the .25mg Klonopin dose? Have you reduced it from a higher level within the last 6 months?
>
> Bob

Bob,

No I haven't reduced it from a higher level. I have been at this level for about a year.

 

Re: Dr. Kramer : Any suggestions or advice - PLEASE » optimistic

Posted by Bob on April 1, 2002, at 23:37:22

In reply to Re: Dr. Kramer : Any suggestions or advice - PLEASE, posted by optimistic on April 1, 2002, at 17:24:09

> > How long have you been at the .25mg Klonopin dose? Have you reduced it from a higher level within the last 6 months?
> >
> > Bob
>
> Bob,
>
> No I haven't reduced it from a higher level. I have been at this level for about a year.

Ok... just wondering. For me, Klonopin dosage reductions do some of what you were describing.

Bob

 

Re: Dr. Kramer : Any suggestions or advice - PLEASE

Posted by Dr. Kramer on April 2, 2002, at 6:09:16

In reply to Dr. Kramer : Any suggestions or advice - PLEASE, posted by Optimistic on April 1, 2002, at 11:38:07

I don't know. All I can tell you is that it's probably not your meds. It may be a form of depression. Some people get more prominent phyical symptoms than actual depressed mood, and depression often is only present in the am's (especially EARLY in the am like yours) and resolves by the pm. I'd suggest you work with your doc to see if combinations of AD's and/or other meds help.

 

Re: Dr. Kramer : Any suggestions or advice - PLEASE

Posted by polarbear206 on April 2, 2002, at 9:31:45

In reply to Re: Dr. Kramer : Any suggestions or advice - PLEASE, posted by Dr. Kramer on April 2, 2002, at 6:09:16

> I don't know. All I can tell you is that it's probably not your meds. It may be a form of depression. Some people get more prominent phyical symptoms than actual depressed mood, and depression often is only present in the am's (especially EARLY in the am like yours) and resolves by the pm. I'd suggest you work with your doc to see if combinations of AD's and/or other meds help.

Optomistic,
What Dr. Kramer explained in his post and what your current problems are very very similar to mine. I tend to have exacerbations of these physical symptoms this time of year when the season's change. Depression that is worse in the morning and gets better during the day and evening
could be a hallmark clue to an underlying "subtle" bipolar disorder. I have had the same prolems with too high of doses of certain antidepressants. I have just starrted on Lamictal, and am hoping this mood stabilizer can be my "main" med and continue with my current antidepressant, but at a lower dose. The older drugs work better for my depressions. I take 100mg of imipramine. I feel more like my old self on this drug verses the SSRI'S.

 

SAD is highly suggestive of Bipolar II (nm)

Posted by Zo on April 3, 2002, at 17:10:56

In reply to Re: Dr. Kramer : Any suggestions or advice - PLEASE, posted by polarbear206 on April 2, 2002, at 9:31:45

 

As are rotten mornings, improved by evening (nm)

Posted by Zo on April 3, 2002, at 17:13:57

In reply to SAD is highly suggestive of Bipolar II (nm), posted by Zo on April 3, 2002, at 17:10:56

 

Re: Any suggestions or advice - Elavil

Posted by dove on April 4, 2002, at 9:51:22

In reply to Re: Dr. Kramer : Any suggestions or advice - PLEASE » Optimistic, posted by fachad on April 1, 2002, at 13:05:04

>
> I don't know what Dr. Kramer will recommend, but I'll offer a suggestion .
>
> Have you ever tried TCAs like Elavil or Doxepin or Pamelor?
>
> My wife had terrible IBS, which is controlled by Elavil. One of her main symptoms was waking up with stomach pain, nausea, and vomiting.
>
>

I went to the link and read the post regarding the IBS symptoms. I was incredibly surprised by the amount of Elavil (Amitriptyline) she required for relief from her symptoms!

I was told that I was in the upper limits when I was taking 150 mgs. per day due to Amitriptyline's toxicity. Though, I was taking it for different reasons, trying to achieve different results, and was taking other meds concurrently. However, 225 mgs. does sound a teeny-bit scary to me, although, she ended up at 150 mgs. for the longterm :o) Everyone is unique in their requirements, sometimes fortunately, other times, not so.

Trying and/or experimenting with a low-dose semi-sedating TCA does sound like a positive possibility. You never know where you'll find relief.

Best of Luck and Better Health too - Optimistic!!!

dove


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