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Dr. Bob is Robert Hsiung, MD,
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Posted by banga on March 8, 2005, at 2:30:42
In reply to Luvox and caffeine, posted by banga on March 8, 2005, at 2:20:11
Is caffeine metabloized by enzyme 2D6? Is it not very un-adaptive for the body to use one enzyme for so many purposes??
Posted by celticmom on March 8, 2005, at 6:58:17
In reply to Luvox and caffeine, posted by banga on March 8, 2005, at 2:20:11
Luvox does amplify the effects of caffeine. We found out soon after putting my son on Luvox the first time. He drank some of my diet soda and became hyper.
I had a similar reaction on an antibiotic recently. After a Latte, I thought my heart was going to explode from my chest.
Posted by celticmom on March 8, 2005, at 7:06:21
In reply to Re: Luvox and caffeine, posted by banga on March 8, 2005, at 2:30:42
banga - I believe that is correct - I think the same enzyme is responsible for breaking down caffeine that breaks down certain meds, Luvox being one.
Posted by ed_uk on March 8, 2005, at 10:40:02
In reply to Luvox and caffeine, posted by banga on March 8, 2005, at 2:20:11
Hi banga,
How are you doing? Have you discontinued the Abilify and reduced the Adderall? Do you think some of your symptoms were due to caffeine?
Best,
Ed.
Posted by Spriggy on March 8, 2005, at 12:11:51
In reply to Re: Luvox and caffeine » banga, posted by ed_uk on March 8, 2005, at 10:40:02
I was on Cipro once for a kidney infection. I remember ANY time I even looked at caffeine (okay, that's a bit of an exaggeration), my heart would palpitate and I thought I was going to have cardiac arrest.So I wouldn't doubt that Luvox could increase the effects of caffeine. I know lots of meds do that.
try decaf coffee and see if that makes any difference.
I know since all this stuff has happened to me, I stay clear of caffeine. I used to be an avid Starbucks gal and Dr. Pepper drinker. Now, I notice my anxiety sky rockets if I even smell the stuff..
Posted by banga on March 8, 2005, at 17:16:19
In reply to Re: Luvox and caffeine » banga, posted by ed_uk on March 8, 2005, at 10:40:02
HI
I do think my sxs (high blood pressure sxs) were from caffeine--didnt take any Adderall yesterday, no abilify either (for two days) and I still felt as though my pressure was up. DUH it only occurred to me later that I was forgetting (ie ignoring) the statements about caffeine and Luvox. Once I decided to stay at a low dose I didnt think it could be such a problem. Obviously all these drugs using the same enzyme amplified everything. This is so annoying, I find a combination that appears to make a difference, and it is difficult to manage. Well I suppose I need to adjust the mix until it works....but I am doubting Abilify could be in the picture, I may be one of the people with too little of this enzyme...with Abilify's long half-life it builds up too quickly. Good emergency drug but I will try to work without it....
Give up coffee? NOt easy at all for me, it is a huge emotional crutch
Posted by Phillipa on March 8, 2005, at 17:41:10
In reply to Re: Luvox and caffeine » ed_uk, posted by banga on March 8, 2005, at 17:16:19
I think I drank tea while on luvox, but it might have been decaf. I didn't know this about luvox. Fondly, Phillipa
Posted by ed_uk on March 9, 2005, at 7:46:36
In reply to Re: Luvox and caffeine » ed_uk, posted by banga on March 8, 2005, at 17:16:19
Hi Banga!
>Give up coffee? NOt easy at all for me, it is a huge emotional crutch
If coffee is VERY stimulating for you at the moment, perhaps you could get by just having a tiny amount- throw the rest of the cup down the sink.
Ed.
Posted by banga on March 10, 2005, at 6:40:53
In reply to Re: Luvox and caffeine, posted by Spriggy on March 8, 2005, at 12:11:51
It is much better now....elimintated Abilify and lessened Luvox to stop the liver stress. I think the Abilify is mostly out of my system. Feeling way better, also taking 20 mg Adderall instead of 30.
Posted by ed_uk on March 10, 2005, at 8:58:29
In reply to Re: Luvox and caffeine, posted by banga on March 10, 2005, at 6:40:53
Hi Banga,
It's good to know you're feeling better :-)
So you're taking,
Adderall 20mg
Desipramine 75mg?
Fluvoxamine ??
Lamictal?Are you going to continue decreasing the Lamictal? It sounds like you probably don't need it anymore.
Ed.
Posted by banga on March 11, 2005, at 6:57:28
In reply to Re: Luvox and caffeine » banga, posted by ed_uk on March 10, 2005, at 8:58:29
Hi Ed,
I am taking
Adderall 20
desipramine 75
luvox 50
lamictal 100and it is doing ok for now, I think there is some difference RE anxiety with the Abilify gone, but I will see if I can increase the luvox a tad and get by without the Abilify. We will see.....
I am a little reluctant to push out the Lamictal immediately, though I douubt it is doing anything--but want to stabilize first completely and understand the amounts I need with the other meds.
Posted by ed_uk on March 11, 2005, at 8:18:33
In reply to Re: Luvox and caffeine, posted by banga on March 11, 2005, at 6:57:28
Hi B!
>I am a little reluctant to push out the Lamictal immediately, though I douubt it is doing anything--but want to stabilize first completely and understand the amounts I need with the other meds.
Perhaps you could wait a couple of months, until you're getting more out of the fluvoxamine, then you could gradually taper the Lamictal.
Ed :-)
Posted by banga on March 13, 2005, at 4:40:59
In reply to Re: Luvox and caffeine » banga, posted by ed_uk on March 11, 2005, at 8:18:33
I felt my mood and anxiety worsening on day 3 off of Abilify. Oh well. I will try 2.5mg every other day. I took some last night and woke up feeling much better already--didnt think it would be so quick. If it were possible to split these pills into thirds or fourths, Id take even less--but they are already tiny....the only option is to smash it and take rather imprecise amounts. this medication being so powerful, I wonder why they have not come up with even smaller doses. Dont suppose it comes in a liquid--?
But I am not happy about it. Because I've noticed that even at this amount I feel a slight tick of having trouble maintaining eye contact in one position--feel my eyes wanting to go left if only slightly and briefly. Is this akasthisia -or worse?
My other option is to try and find a different source of a 5ht2a antagonist. I am quite sure this is key for me. Any ideas that dont mean instant weight gain? Very tiny amounts of Remeron?? Of tricyclics, do you know which has the most potent 5ht2a action, to get away with the smallest amounts?
Posted by ed_uk on March 13, 2005, at 10:15:00
In reply to Re: Back on Abilify? » ed_uk, posted by banga on March 13, 2005, at 4:40:59
Hi Banga!!!!
>I will try 2.5mg every other day.
I think that is a good idea. Once you have been on the fluvoxamine for a few months you could attempt a gradual taper of the Abilify.
>I wonder why they have not come up with even smaller doses.
I suppose it's because Abilify's not approved for anxiety, where low doses are the norm. You're lucky - the smallest tablet available in the UK is 10mg!
>Because I've noticed that even at this amount I feel a slight tick of having trouble maintaining eye contact in one position--feel my eyes wanting to go left if only slightly and briefly. Is this akasthisia -or worse?
It sounds like a dystonia, same as you had with your tongue.
>Any ideas that dont mean instant weight gain?
I must admit, I don't have any great ideas.
>Of tricyclics, do you know which has the most potent 5ht2a action, to get away with the smallest amounts?
The ones that cause the most weight gain! Amitriptyline and trimipramine - I expect you'd gain weight, even with a low dose. I'm hoping that you won't need any additional medication once you've been on fluvoxamine for a few weeks.
Ed xx
Posted by banga on March 13, 2005, at 10:52:23
In reply to Re: Back on Abilify? » banga, posted by ed_uk on March 13, 2005, at 10:15:00
>You're lucky - the smallest tablet available in the UK is 10mg!
Now that seems ridiculous...I cannot imagine the side effects I would have on that amount....maybe I will try crushing them....>I'm hoping that you won't need any additional medication once you've been on fluvoxamine for a few weeks.
I certainly hope not to have to add more...my goal was a little of 2 or 3 medications, not 5!!
Posted by ed_uk on March 13, 2005, at 11:02:01
In reply to Re: Back on Abilify?, posted by banga on March 13, 2005, at 10:52:23
Hi!
>maybe I will try crushing them....
They're not enteric-coated or film-coated are they? I don't think they are, just check the package insert.
Will you try 1.25mg/day, or maybe 0.625mg!
Ed xx
Posted by banga on March 13, 2005, at 15:36:56
In reply to Re: Back on Abilify? » banga, posted by ed_uk on March 13, 2005, at 11:02:01
I really dont know what to do....even at this dose today (Abilify), I feel the dystonia and shaky--really difficult to bear as I dont feel great and I think my sister-in-law and brother may notice this and its embarrassing. It is unclear to me why it is actually worse today than yesterday (I didn't take the Abilify last night)....
It's like a tease, feeling good one day, able to deal with life and actually envision a future, and then distressed and almost devastated the next. For no reason.I will have to try without the Abilify somehow. I think with the long half-life and interactions with desipramine and Luvox it is too much--too unpredictable that is. I will have to work with the other pieces.
Hm. An angle I haven't considered--I take the LUvox 1x/day (at night). Maybe mood swings could be due to Luvox levels swinging? I unfortunately have not made a note of the pattern...but maybe I do better in the am than pm--when perhaps Luvox is at its lowest?
Sorry, just thinking out loud here--
Posted by banga on March 13, 2005, at 15:40:02
In reply to Re: Back on Abilify?, posted by banga on March 13, 2005, at 15:36:56
Maybe that is what is logical at this moment--try and alter (space out) dosages? Right now I take all but the Adderall at night.
Posted by ed_uk on March 13, 2005, at 15:48:08
In reply to Re: Back on Abilify?, posted by banga on March 13, 2005, at 15:36:56
Hello,
>I will have to try without the Abilify somehow.
I can't remember why you discontinued Risperdal, did it cause weight gain? Risperdal has the advantage of coming in very low doses, half-scored 0.5mg tablets. Perhaps you could replace the Abilify with a low dose of Risperdal.
>but maybe I do better in the am than pm--when perhaps Luvox is at its lowest?
I think you should try taking 25mg every 12 hours, a steady level is usually best in the long run.
I don't feel well today either, I feel very fatigued. My body is aching and so are my eyes, even though I had plenty of sleep.
Ed xx
Posted by banga on March 13, 2005, at 15:53:04
In reply to Re: Back on Abilify? » banga, posted by ed_uk on March 13, 2005, at 15:48:08
Thanks Ed!
How are things going for you in general? YOu comment and help others so much, I rarely hear how things are on your end...
Posted by banga on March 13, 2005, at 16:06:10
In reply to Re: Back on Abilify? » ed_uk, posted by banga on March 13, 2005, at 15:53:04
...And do you have an amazing memory or do you take notes?? I took risperdal--I can't remember the dose--but stopped due to fatigue and dislike with how it affects hormonal systems. But I dont recall having dystonia....Perhaps`you are right--a low dose may do OK. If I don't restabilize with these other meds I will perhaps try it out when I get home...
Posted by ed_uk on March 13, 2005, at 16:18:09
In reply to Re: Back on Abilify? » ed_uk, posted by banga on March 13, 2005, at 15:53:04
Hi B!
I'm not doing too bad thanks, I've got exams in June, not sure how I'm gonna do. The pharmacy course is so dull, it's sad really because it could have been interesting - we'd need a whole new set of lecturers for that to happen though! It's essentially a course in pharmaceutical science, it's not a clinical course at all. We don't learn that much relevent stuff to be honest, most of the lecturers are chemists. In many cases, they've got no idea what drugs are even available at the moment.
I never wanted to do pharmacy really, I wanted to do medicine but my personality got in the way, I would have had a breakdown if I'd done medicine.
So, as ever, I'm addicted to the internet and not doing as much work as I should. This semester's gone a lot better than last semester though - which was a disaster. I have to do the January exams in August, it's not going to be fun, I don't know how I'm going to motivate myself to revise. I'm gonna try to get another job in a pharmacy over the summer, I liked it last summer, it was better than being at university. The people you work with make all the difference, if they're nice it's fun but if they're not it's horrible. I worked in a few different pharmacies last summer, some I enjoyed but others were a nightmare. Not sure what I'm gonna do about the sweating, last summer I was dripping sweat over the counter thanks to the ADs I was on. Tried Inderal but it didn't help, I hate Inderal anyway, it makes me feel cr*p and it doesnt do anything for my anxiety.
About you...
What happened with the Risperdal?Ed.
Posted by ed_uk on March 13, 2005, at 16:30:42
In reply to Re: Back on Abilify?, posted by banga on March 13, 2005, at 16:06:10
Hello!
>And do you have an amazing memory or do you take notes??
I have a good memory for medication but a terrible memory for everything else, I kid you not!
>I can't remember the dose.
Can you ask your doc to look in your medical notes?
Side-effects are very dose-dependent with Risperdal, you could try 250mcg/day if your current combination isn't satisfactory.
>If I don't restabilize with these other meds I will perhaps try it out when I get home.
Yes, it's important to wait and see how you do on fluvoxamine. You don't need any more confusion about which meds are helping!
Ed x
Posted by banga on March 13, 2005, at 16:40:21
In reply to Re: Back on Abilify? » banga, posted by ed_uk on March 13, 2005, at 16:18:09
I can truly relate to dropping the med school due to personality interference. It is a shame that school is boring for you at the moment. Any hope that could change soon, some more life-relevant angle in future classes, or with these profs there is no hope?
So are you off all ADs at the moment? How would you characterize your diagnosis?As for the risperdal--I probably did also gain weight on the risperdal, I can't well remember. Was not on it for more than a month. I just remember becoming intensely fatigued, in fact quite ill and dizzy so that I could not exersise though I truly wanted to.
Do you think I should space out all the meds--say 25mg desip., 25mg Luvox, 50mg Lamictal am, the rest in pm?
Posted by banga on March 13, 2005, at 16:49:36
In reply to Re: Back on Abilify? » ed_uk, posted by banga on March 13, 2005, at 16:40:21
LOL it would be a victory for both of us if I stay on one med schedule for more than 24 hours! Though in truth I do think I am struggling more because of the interactions and resultant swings in blood levels....I will make a note on how I feel in the am. vs pm. "see" you tomorrow...
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