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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 28. This is the beginning of the thread.
Posted by partlycloudy on April 15, 2005, at 7:31:39
Seems that when I was increased to 1mg of Klonopin for my anxiety that it has worsened my depression. I was sent home from work yesterday after crying non-stop for an hour over *NOTHING*. I hate this tight rope walking.
So - do we increase my Cymbalta from 30mg to 60mg for the depression?
And if we do that, do I have to increase the propanolol to counteract the high blood pressure the Cymbalta causes at higher doses in me?
Do I dump the Klonopin (no, please - it's the best I have felt in months) and go back to xanax?Oh, and I have a cold, so I'm already feeling like dog poopy.
pity partying partlycloudy
Posted by banga on April 15, 2005, at 7:51:54
In reply to Having a little crisis here..., posted by partlycloudy on April 15, 2005, at 7:31:39
> Seems that when I was increased to 1mg of Klonopin for my anxiety that it has worsened my depression. I was sent home from work yesterday after crying non-stop for an hour over *NOTHING*. >
> pity partying partlycloudyHi!
I had the same happen with klonopin--complete meltdown.. YOu said you increased the klonopin--could you for now just go back down to the dosage you were at? Somehow I dont think increasing the Cymbalta is the thing to do just yet, since this is a reaction to the klonopin. Was the lower dose of klonopin working??There are other meds out there if klonopin does not work out....
Posted by partlycloudy on April 15, 2005, at 8:07:30
In reply to Re: Having a little crisis here..., posted by banga on April 15, 2005, at 7:51:54
When I was at .5mg of the Klonopin, it was not at all effective for the anxiety. And I hadn't been happy with xanax mostly because of the suddenness of when it wears off (made me feel even worse than before).
I've also tried vistaril (that was good for a snooze and nothing else).This depression is crippling me. Very difficult keeping my happy face plastered in place at work (and I'm a receptionist, so there's no place to hide either). Just trying to get through the day without another meltdown, you know?
Thanks, Banga.
Posted by banga on April 15, 2005, at 8:40:13
In reply to Re: Having a little crisis here... » banga, posted by partlycloudy on April 15, 2005, at 8:07:30
> When I was at .5mg of the Klonopin, it was not at all effective for the anxiety.
> This depression is crippling me. Very difficult keeping my happy face plastered in place at work (and I'm a receptionist, so there's no place to hide either). Just trying to get through the day without another meltdown, you know?
>Try not to dwell on negative stuff, imagine the people naked or something, or how they would look with a clown nose on...
Try not to worry about all this and what to do, that will only make thing more stressful. just get through the day. It'll be solved soon. I can tell you bad jokes and lighthearted quips...When you have time, you can tell me if you have tried anything else. And what your symptoms are overall. I assume it is major depression and anxiety....
As I said, there are other medications to try. Some people do great on klonopin, but some dont and maybe something else would work better with your chemistry. lorazepam, Valium, etc...
And for me, actually tiny doses of some of the atypical antipsychotics did wonders for my depression. Not trying to sell you on that, just saying how many options are out there...
Posted by banga on April 15, 2005, at 8:49:52
In reply to Re: Having a little crisis here... » banga, posted by partlycloudy on April 15, 2005, at 8:07:30
Oh and also--was the 30mg Cymbalta ever effective?
I wonder if you would have less problems with side effects if you went up just a hair--to 40 or 50mg.
Posted by partlycloudy on April 15, 2005, at 9:12:51
In reply to Re: Having a little crisis here... » partlycloudy, posted by banga on April 15, 2005, at 8:49:52
Thanks again, Banga... my dx is mild bipolar2, GAD and panic attacks. I have a history of alcoholism, though I'm not active presently - but because of my addictive-prone qualities my p-doc and I are a bit cautious with benzos...
I have been on, at various times and in varying combinations:
Paxil
Celexa
Ativan (briefly)
Buspar
Vistaril
Wellbutrin
Effexor
XanaxI think I've just come through a period of hypomania, as I was actually creative and productive for a whole month!! until the last few days. Luckily I did not spends loads of dosh, but my kitchen is only halfway decorated and now I don't know when or if I'll be able to finish it before I change my mind or chicken out on the whole scheme (rather extreme for me)!!!
I have a call in to my p-doc regarding upping the Cymbalta, but I'm extremely prone to elevated blood pressure on this med and effexor.
Posted by partlycloudy on April 15, 2005, at 9:21:49
In reply to Re: Having a little crisis here... » banga, posted by partlycloudy on April 15, 2005, at 9:12:51
trazodone, and zyprexa.
I think that's it so far.
Posted by banga on April 15, 2005, at 9:25:53
In reply to Re: Having a little crisis here... » banga, posted by partlycloudy on April 15, 2005, at 9:12:51
I'm not sure how effective each of these meds were for you...if they by chance have not been effective, I am not quite sure Cymbalta will be...but maybe they were effective at some points?
first thing that comes to mind is whether you and the pdoc have considered a mood stabilizer in the picture. I am taking Lamictal with a list of other meds...alone it didnt do enough for me, but in combination i think it does smooth things out...it is rated as top medication for BP by people on the remedyfind board.I have major depression, with severe generalized anxiety. I also take desipramine, Adderall, Abilify, luvox--mostly each one is at a subtherapeutic dose. My new theory is that a little bit of several things is better than a ton of one thing....and I too have a hx of alcohol dependence.
Also, have you ever tried tricyclics? One of the side effects people complain about on them is hypotension--so that side effect probably wouldnt be a problem for you! But with the BP diagnosis, I had always understood things that target serotonin can bring out mania/hypomania...
These are all just IMO comments of course.
Posted by banga on April 15, 2005, at 9:26:31
In reply to oh, and...., posted by partlycloudy on April 15, 2005, at 9:21:49
How was the Zyprexa for you?
Posted by partlycloudy on April 15, 2005, at 9:32:11
In reply to Re: oh, and...., posted by banga on April 15, 2005, at 9:26:31
It made me into a very sleepy, ravenous zombie. Not a good choice!
I really, really appreciate your input, Banga.
Posted by banga on April 15, 2005, at 9:56:26
In reply to Re: oh, and.... » banga, posted by partlycloudy on April 15, 2005, at 9:32:11
> It made me into a very sleepy, ravenous zombie.
Sounds like me when I wake up in the morning!!
Given your diagnosis, I am curious as to why mood stabilizers have not been suggested to you.
In terms of mood stabilizers, Lamictal is supposedly very good for people who primarily are more often in the depressive end of the mood spectrum..you have to start it up really really slowly, as it can cause a serious rash; but if taken slowly enough it sounds as though this can be avioided. I had no problems.
Another medication that people talk about as being good for BP and anxiety is Seroquel. I dont know about the panic attacks though... you can see I am exploring these meds myself right now from my posts, a relative needs help in figuring out her meds for BPI.
So have you seen your boss yet and imagined him/her naked? Or for the fun of it, you could pretend to have Tourettes syndrome just for today and spontaneously yell out obscenities....hey, it could cheer you up.
Posted by partlycloudy on April 15, 2005, at 10:29:03
In reply to Re: oh, and...., posted by banga on April 15, 2005, at 9:56:26
...my boss just asked me how much warning I could give her before I crumple into tears so they can make sure no one knows when I have fallen apart.
I started to cry again in reply....
today cannot end too quickly for me today.
this bites the big one.
Posted by ed_uk on April 15, 2005, at 10:33:27
In reply to Actually, » banga, posted by partlycloudy on April 15, 2005, at 10:29:03
Hi,
Perhaps you could replace Klonopin with a different long-acting benzo such as Librium.
Regards,
Ed.
Posted by banga on April 15, 2005, at 10:37:02
In reply to Actually, » banga, posted by partlycloudy on April 15, 2005, at 10:29:03
> ...my boss just asked me how much warning I could give her before I crumple into tears so they can make sure no one knows when I have fallen apart.
OH you poor thing!!! I give you a hug!! Bad timing with my jokes..the day WILL end, you WILL get help. It WILL be better. Just hang in there!
try to tell yourself it is just a reaction to the meds, it is just the meds, I am OK, it is just a biochemical thing right now....picture what nice thing you will do for yourself when you get home, when you have time to comfort yourself. A bath, hot chocolate, your favorite meal whatever helps you.
Posted by partlycloudy on April 15, 2005, at 10:46:38
In reply to Re: Actually,, posted by banga on April 15, 2005, at 10:37:02
Posted by partlycloudy on April 15, 2005, at 10:48:23
In reply to Re: Actually, » partlycloudy, posted by ed_uk on April 15, 2005, at 10:33:27
Hmm. Up until now my p-doc has wanted to steer away from mood stabilizers and I don't really know why. Is that what Librium is?
Posted by ed_uk on April 15, 2005, at 10:56:32
In reply to Re: Actually, » ed_uk, posted by partlycloudy on April 15, 2005, at 10:48:23
Hi!
Librium is a long-acting anti-anxiety drug. It's a benzo like Klonopin. You're probably thinking of lithium.
Regards,
Ed.
Posted by Racer on April 15, 2005, at 12:34:20
In reply to Re: Actually, » ed_uk, posted by partlycloudy on April 15, 2005, at 10:48:23
That I think you are both beautiful and a great coffee date?
Otherwise, I'd have to second Ed with the long acting anxiolytic. You know me -- ninety percent of what I know about meds is based on what my vets have told me, but I know there are a couple of meds that are commonly used after surgery -- reserpine is the only name I can come up with off the top of my head -- but they are usually given in monthly injections, so when they say "long acting" they apparently mean just that...
Best love to you, my dear and treasured friend. Email will follow as soon as I get my communication ability back.
Posted by partlycloudy on April 15, 2005, at 13:24:01
In reply to Does it help to know... » partlycloudy, posted by Racer on April 15, 2005, at 12:34:20
(((Racer))) I sure know what it's like to lose the ability to communicate! In yesterday's ill-fated department meeting I looked like a deer caught in the headlights.
And thanks - I needed your words, dear. My T is suggesting that I would be more comfortable working part time - I just don't know. If this crying is due to a maladjustment (great word) of medications, I *should* be OK once I get it figured out. Otherwise, there is no way I can continue tearing myself up - and making a poor impression at the front desk...
Still waiting on that call back from the p-doc. She probably has 20 callers worse off than I to get to first. Did you know that I live in one of the most clinically depressed cities in America? We are #3! We are #3!!! All this freeeking sunshine and we're all on ADs while we soak it up.
Sheesh.My T also told me how STRONG and CAPABLE and WONDERFUL a person I am. Is that like LIONS, and TIGERS, and BEARS, OH MY! ?
Be well, and thanks all!
pc
Posted by tendency on April 15, 2005, at 15:38:37
In reply to Having a little crisis here..., posted by partlycloudy on April 15, 2005, at 7:31:39
> Seems that when I was increased to 1mg of Klonopin for my anxiety that it has worsened my depression. I was sent home from work yesterday after crying non-stop for an hour over *NOTHING*. I hate this tight rope walking.
sorry to hear that. it's so odd as i find klonopin helps my depression. sure is bizarre how people react to these meds
Posted by tendency on April 15, 2005, at 15:46:05
In reply to Re: Having a little crisis here... » banga, posted by partlycloudy on April 15, 2005, at 8:07:30
> When I was at .5mg of the Klonopin, it was not at all effective for the anxiety. And I hadn't been happy with xanax mostly because of the suddenness of when it wears off (made me feel even worse than before).
what did you feel when it would wear off? just more anxious? or other symptoms as well?
Posted by partlycloudy on April 15, 2005, at 16:39:33
In reply to Re: Having a little crisis here... » partlycloudy, posted by tendency on April 15, 2005, at 15:46:05
when the xanax wore off i would have worse anxiety than before i took the pill. and i landed with quite a bump.
i never heard back from my p-doc today and I am quite distraught at being ignored when I was crying on her answering machine this morning, so I am self adjusting my meds to:
60mg of cymbalta (up from 30mg)
.5mg of klonopin (down from 1mg) to taper off eventually
.25mg of xanax for anxiety if the smaller dose of klonopin doesn't work - and I don't expect it to.
monitor my blood pressure (i have a wrist cuff) though when it goes up i can hear the blood pumping in my ears, in case it goes up with the higher dose of cymbalta.i don't think these changes will do anything worse than where I am now - anyone see any problems with it?
Posted by Phillipa on April 15, 2005, at 19:18:54
In reply to to tendency and my other helpers..., posted by partlycloudy on April 15, 2005, at 16:39:33
I just got home and read your Thread. Sounds like Banga has given you a lot of good advice. I know Ed like librium and he is the drug expert, but personally after trying both xanax and klonopin, I find that valium works better for me. Have you read the Threads on how some posters take only crystals of cymbalta and it works for them? I'm really sorry you're having such a hard time today. I don't want to trivialize how you feel but it is kind of cute that your Boss said what he/she did. Maybe being home this weekend will help. Just keep an eye on the BP. Wish you the best of luck! Fondly, Phillipa
Posted by banga on April 15, 2005, at 19:25:50
In reply to to tendency and my other helpers..., posted by partlycloudy on April 15, 2005, at 16:39:33
> 60mg of cymbalta (up from 30mg)
> .5mg of klonopin (down from 1mg) to taper off eventually
> .25mg of xanax for anxiety if the smaller dose of klonopin doesn't work - and I don't expect it to.How serious was the high blood pressure issue the last time it happened? How quickly? I would really go by that for the moment. Did the higher dose of Cymbalta seem to help last time?
It's good that you have some xanax around to tie you over at least....
I am so sorry about your rough day. Noone needs that. And yes, it is SO frustrating that doctors dont respond.. you feel so helpless...
Do you have time to rest up a bit this weekend? This evening?All the best,
B.
Posted by partlycloudy on April 16, 2005, at 5:48:08
In reply to Re: to tendency and my other helpers... » partlycloudy, posted by banga on April 15, 2005, at 19:25:50
My blood pressure creeps up on Cymbalta and did also on Effexor, up to about 150/100. I should have listed that I take a min. dose of propanolol - 20mg to keep it in check.
thanks heavens for the weekend. I feel better this morning.
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