![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by sdjeff on April 20, 2004, at 0:50:17
I trust my pdoc but this seems like a bit much.
I have MDD w/ GAD (or BP2, still undecided) and BPD traits. I also have a flavor of CFS w/pain.
My current cocktail is:
20 mg Geodon, in the morning, titrating up.
5 mg Zyprexa in the morning
25 mg Nortripyline at night
.25 mg Halcion at nightI treat the muscle pain with OTC stuff like Ibuprofen and Aleve and the occasional Ultracet or Darvon. Not very effective but all I can afford to do.
The zyprexa is sedating, I think the Geodon helps with that. Both AP's help w/delusions, paranoia, irritability and mild visual disturbances. the Halcion is just for sleep. The AP's make me super quiet. Frustratingly quiet.
The Nortriptyline is for the depression. I had a manic episode on Amitryptaline several years ago so we're being careful with this one. I am hypersensetive to AD's, AP's and other neuroleptics like lithium, tegretol, etc.
Right now I feel flat and pretty depressed. Maybe overmedicated. My functioning is better on this combo than any other, but I still have problems w/suicidal ideation, mild akathesia and slower cognition. On the upside, my anxiety is all but wiped out.
Any thoughts?
Posted by Sad Panda on April 20, 2004, at 11:44:24
In reply to What do you think of this crazy combo?, posted by sdjeff on April 20, 2004, at 0:50:17
> I trust my pdoc but this seems like a bit much.
>
> I have MDD w/ GAD (or BP2, still undecided) and BPD traits. I also have a flavor of CFS w/pain.
>
> My current cocktail is:
> 20 mg Geodon, in the morning, titrating up.
> 5 mg Zyprexa in the morning
> 25 mg Nortripyline at night
> .25 mg Halcion at night
>
> I treat the muscle pain with OTC stuff like Ibuprofen and Aleve and the occasional Ultracet or Darvon. Not very effective but all I can afford to do.
>
> The zyprexa is sedating, I think the Geodon helps with that. Both AP's help w/delusions, paranoia, irritability and mild visual disturbances. the Halcion is just for sleep. The AP's make me super quiet. Frustratingly quiet.
>
> The Nortriptyline is for the depression. I had a manic episode on Amitryptaline several years ago so we're being careful with this one. I am hypersensetive to AD's, AP's and other neuroleptics like lithium, tegretol, etc.
>
> Right now I feel flat and pretty depressed. Maybe overmedicated. My functioning is better on this combo than any other, but I still have problems w/suicidal ideation, mild akathesia and slower cognition. On the upside, my anxiety is all but wiped out.
>
> Any thoughts?
>Take Zyperxa at night & ditch Halcion? Ramping up only one at a time might be a good idea too.
Cheers,
Panda.
Posted by Keith Talent on April 21, 2004, at 21:35:08
In reply to Re: What do you think of this crazy combo? » sdjeff, posted by Sad Panda on April 20, 2004, at 11:44:24
I'd ditch the antipsychotics and Halcion. Take Klonopin twice a day for the anxiety. Up the nortriptyline to whatever it takes to stop you feeling flat/lifeless/depressed. If there's any hint of switching into hypomania, add lithium. If you need something for sleep, add Ambien (if that doesn't work, go back to Halcion). The nortriptyline, at a decent dose, can help with pain.
Posted by HappyGirl on April 22, 2004, at 18:06:24
In reply to What do you think of this crazy combo?, posted by sdjeff on April 20, 2004, at 0:50:17
Hi sdj:
Zyprexa and Geodon combo. is a terrific combo. for you, but sounds to me like your system started reacting other direction, ... 'Too' much for it to withstand although all those chemical of your brain seems working as hard as it can.
In my suggestion, ... probably, try to 'reduce' a bit, ... like 5 mg. one evening/night and 2.5 mg. next evening/before the bed.
Also, ... recalling your 'AD fear,' ... if you are able to remember, ... the med., 'Serzone' is a good med. to those who have no tolerance to AD that is at least in my case. I cannot tolerate those SSRIs and other forms of AD, then my pdoc. rxed 'Serzone' for the 'last resort' that turned out to be 'Wonder' for me. However, there is a lot of 'Hyper' on Serzone, ... then the best best is you need to ask your pdoc. on this regard whether you're able to take this med. as you need to have 'strong liver' and good confidence in all 'liver' related issues.
H.G.
Posted by HappyGirl on April 22, 2004, at 18:17:02
In reply to What do you think of this crazy combo?, posted by sdjeff on April 20, 2004, at 0:50:17
Hi sdj:
Sorry, .... I didn't read the upper part of your post, regarding the following:
>>> I treat the muscle pain with OTC stuff like Ibuprofen and Aleve and the occasional Ultracet or Darvon. Not very effective but all I can afford to do. <<<<In my knowledge along with my personal experience, some of 'Pain Killer' med. stated the above might aggrevate the depressive side of your problems, Bipolar and few more, ... just forget those names tho', ...
Then, before taking any 'Pain Medications,' you need to ask your pdoc., because there is/are 'bad interaction' between the med. combo. and pain meds.
H.G.
Posted by crazychickuk on April 23, 2004, at 3:15:18
In reply to Addendum//Re: Pain Killer Meds., posted by HappyGirl on April 22, 2004, at 18:17:02
You take to much in my opinion....
Ibrupafen is safe to take as long as u aint got asthmal, stomach ulcers or u aint taken warfin etc..
most antidepressants r good for pain and klon any benzos will be good for pain cus they relax the muscles..
Posted by Sad Panda on April 23, 2004, at 7:53:21
In reply to Addendum//Re: Pain Killer Meds., posted by HappyGirl on April 22, 2004, at 18:17:02
> Hi sdj:
> Sorry, .... I didn't read the upper part of your post, regarding the following:
> >>> I treat the muscle pain with OTC stuff like Ibuprofen and Aleve and the occasional Ultracet or Darvon. Not very effective but all I can afford to do. <<<<
>
> In my knowledge along with my personal experience, some of 'Pain Killer' med. stated the above might aggrevate the depressive side of your problems, Bipolar and few more, ... just forget those names tho', ...
> Then, before taking any 'Pain Medications,' you need to ask your pdoc., because there is/are 'bad interaction' between the med. combo. and pain meds.
> H.G.
>
>Well spotted HappyGirl,
Ultracet & Darvon are Serotonin Reuptake Inhibitors. If you have trouble with SSRI's, then these, especially Ultracet, are going to cause you grief. They aren't supposed to be mixed with AD's either.
Cheers,
Panda.
Posted by sdjeff on April 24, 2004, at 22:57:04
In reply to Re: Addendum//Re: Pain Killer Meds., posted by Sad Panda on April 23, 2004, at 7:53:21
> > In my knowledge along with my personal experience, some of 'Pain Killer' med. stated the above might aggrevate the depressive side of your problems, Bipolar and few more, ... just forget those names tho', ...
> > Then, before taking any 'Pain Medications,' you need to ask your pdoc., because there is/are 'bad interaction' between the med. combo. and pain meds.
> > H.G.
> >
> >
>
> Well spotted HappyGirl,
>
> Ultracet & Darvon are Serotonin Reuptake Inhibitors. If you have trouble with SSRI's, then these, especially Ultracet, are going to cause you grief. They aren't supposed to be mixed with AD's either.
>
> Cheers,
> Panda.
>
>Wow, well said and said again. The Utracet and Darvon are taken pretty rarely. I guess that's what happens when you rely on the pill book and getpain killer on the sly. (yes, I know.) SO that will stop. I'm sure the OTC stuff is OK, right? (aleve, ibuprofin, tylenol)
Thanks guys.
Posted by Sad Panda on April 25, 2004, at 1:00:20
In reply to Re: Addendum//Re: Pain Killer Meds., posted by sdjeff on April 24, 2004, at 22:57:04
> > > In my knowledge along with my personal experience, some of 'Pain Killer' med. stated the above might aggrevate the depressive side of your problems, Bipolar and few more, ... just forget those names tho', ...
> > > Then, before taking any 'Pain Medications,' you need to ask your pdoc., because there is/are 'bad interaction' between the med. combo. and pain meds.
> > > H.G.
> > >
> > >
> >
> > Well spotted HappyGirl,
> >
> > Ultracet & Darvon are Serotonin Reuptake Inhibitors. If you have trouble with SSRI's, then these, especially Ultracet, are going to cause you grief. They aren't supposed to be mixed with AD's either.
> >
> > Cheers,
> > Panda.
> >
> >
>
> Wow, well said and said again. The Utracet and Darvon are taken pretty rarely. I guess that's what happens when you rely on the pill book and getpain killer on the sly. (yes, I know.) SO that will stop. I'm sure the OTC stuff is OK, right? (aleve, ibuprofin, tylenol)
>
> Thanks guys.
>Hi SDJ,
What's in Aleve? Pure opiate type drugs such as codiene, oxymorphone(Dilaudid), oxycodone(OxyContin, Percoset, Percodan) & morphine are the drugs that would be best to take with AD's, but unfortuantely they are the hardest to get. The other 'opiates' are SRI's to some degree, pethidine(Demerol), Tramadol(Ultram, Ultracet), Methadone, Fentnyl are probably best avoided unless you take them continuosly. Your best bet for long term pain is probably going to be Nortriptyline if you can get up to a good dose without going manic.
Cheers,
Panda.
Posted by sdjeff on April 25, 2004, at 17:09:00
In reply to Re: Addendum//Re: Pain Killer Meds. » sdjeff, posted by Sad Panda on April 25, 2004, at 1:00:20
Aleve is Naproxen Sodium. I wish I could get this fatigue and pain under control, it sucks having what feels like two distinct conditions to manage.
<sigh>
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.