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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by pretty_paints on August 10, 2005, at 14:11:08
Hello
I am on an inreasing regime of Clozapine. I'm currently at 225mg.
I am absolutely shattered each day. I CANNOT keep awake at all. I have four days leave from hospital, so the "crisis team" are visiting me twice a day to take my temperature and blood pressure. The crisis team woke me at midday today and completely woke me up. Then I crashed out until my mum came in at about 5pm, slept all day. The "crisis team" nurse said the tiredness should wear off after a few weeks. I've been on Clozapine for two weeks now though and I'm still sooo tired. I will sleep for a whole day and a whole night EASILY.
Is this tiredness ever going to ease off?? I'm worried that it's going to mean I have to stop taking the drug. Which is a big ARRGH.
Lots of love, ZzZzZzzzz.....
Posted by ed_uk on August 10, 2005, at 14:40:35
In reply to Clozapine - will this tiredness get any better?, posted by pretty_paints on August 10, 2005, at 14:11:08
Hi Katie!
>I'm currently at 225mg.
Nearly at 300mg - you'll soon be out of hospital :-)
>I CANNOT keep awake at all.
Clozapine is usually very sedating. The sedation will decrease but it won't disappear completely. I imagine your doc will want to keep you on 300mg for a few weeks/months to assess its effectiveness. I think you'll feel better once you've been on a stable dose for a while.
Love Ed xxx
Posted by Phillipa on August 10, 2005, at 20:51:17
In reply to Re: Clozapine - will this tiredness get any better? » pretty_paints, posted by ed_uk on August 10, 2005, at 14:40:35
Hi Katie! When I worked on the psych unit quite a few of the patients were on Clonazapine. They ALL spent all their time in bed. But it was an amazing drug! Those whose symptoms kept bringing them back in the hospital did very well. They stayed very sleepy for quite a while. But the important thing is they got better. No delusions, hallucinations, no psychotic episodes. Of course the weekly blood draws. I know this is hard for you but it will get better. As Ed said you're almost at your targeted dose! Hang in there. Fondly, Phillipa
Posted by pretty_paints on August 11, 2005, at 7:41:12
In reply to Re: Clozapine - will this tiredness get any better?, posted by Phillipa on August 10, 2005, at 20:51:17
Hi guys
I have been home for a few days now. I actually don't like it at all, I don't feel safe. I was getting used to things in hospital, food there all the time, no stress. I feel like I've been turfed out of the place, they just decided that I should leave. There are plenty of people who seem to be just fine who have been in there months and months. I can't help feeling jealous in a way. Why are they allowed the care but not me? Have I done something wrong? Is everyone angry at me?
Last night the crisis team called and took my blood pressure sitting down and standing up. Apparently it was too low standing up, so they told me not to take last nights or this mornings dose of Clozapine. They came out today with the doctor and measured it again, and now they are saying they are going to keep this dose for 4 days and then if my blood pressure stabilises, start increasing it again. I'm supposed to drink lots of coffee (yuk).
I feel totally weird and different today. Maybe it's because I haven't taken any of the drug today. My head feels in pieces, like I can't link anything up. It's all disjointed and wrong. I feel really low too, maybe even a bit depressed. I can't see things getting any better just coz of a stupid drug. I feel like this is the way it's going to be forever.
I'm starting the MWF (monday, wednesday, friday) group tomorrow. It's from 10am-2pm. However, i did it before in the past, and it just makes me feel like im taking a step back and im never going to get better. I think I actually had got used to things in hospital and coming out is quite a shock (even though at the time I said i hated it).
Anyway hope you are all ok.
speak again soon
kate xx
Posted by ed_uk on August 11, 2005, at 15:23:22
In reply to Low blood pressure, posted by pretty_paints on August 11, 2005, at 7:41:12
Hi Katie!
>I have been home for a few days now.
:-)
>Have I done something wrong? Is everyone angry at me?
Of course not! .....but you don't need to be in hospital anymore. You only went in to hospital to start clozapine. You *are* safe at home, your parents will take good care of you :-) :-) :-)
>I feel totally weird and different today. Maybe it's because I haven't taken any of the drug today. My head feels in pieces, like I can't link anything up. It's all disjointed and wrong. I feel really low too, maybe even a bit depressed.
You'll feel better when you've take your next dose of clozapine, you might be having some withdrawal symptoms.
Lots of love
Ed xoxo
Posted by med_empowered on August 11, 2005, at 17:22:59
In reply to Re: Low blood pressure » pretty_paints, posted by ed_uk on August 11, 2005, at 15:23:22
Sorry about your side-effects :-( Clozapine can be really, really rough. On the plus side...EPS and tardive dyskinesia are rare on clozpine (I think the official line is that Clozapine doesn't cause TD, though I've heard some conflicting reports on that. Anyway, its incredibly rare). The low blood-pressure thing and the sedation, salivation must be awfully tiring and I can understand how you feel like you you're moving backwards, but I really think you seem to be making progress. As for the hospital...its understandable to miss the hospital; everything was laid out for you, everyone was focused on helping you get better but...its not some place you should be long-term. The reason clozapine and the newer antipsychotics are used is because they give patients a much, much better chance of living a happy, successful, independent life than the old drugs or long-term hospitalization. Try to "re-frame" the situation; instead of looking back at the hospital stay and missing it, try to appreciate what you have now--more freedom, more responsibility, a more rich and varied life. Also, try to make some friends and acquaintances and do what you can to enrich your social circle. WHen I get lonely, I actually miss my hospital stay a bit, too...but then I remember: I hated it there. The staff was bitchy, my shrinks was an *ss, and everything was controlled without any regrad for what *I* might want or need, or what was truly important to *me*. But then, when I make it a point to get out more, spend some more time with friends...I start to feel better. A lot better. Even when we fight or just have boring days together, being around people I know and like and trust in the "real world" setting makes me realize that my hospital stay wasn't that great, and that I really DO NOT want to go back there; for all its ups and downs, life "on the outside" is definitely the way to go...IF you have social support. The only thing I really miss about the hospital is the social support; the staff wasn't so great (sometimes mean, sometimes just condescending...they did what they could, I think), but the support of talking to bright, imaginitive, but troubled people who, like me, were trying to make sense of their lives and their place in the world gave me an experience of support and peace that I will probably never be able to re-create. But..that's OK. I took what I could from the experience, bitched about it alot, and now I think I'm all the better for it. So please....before you gloss over your hospital stay and begin to miss it, remember that the world outside has a LOT to offer you, and you can take what you learned from the hospital, and what happened there (good AND bad) and go forth and do better and be better than you ever have before.
Posted by med_empowered on August 11, 2005, at 17:27:37
In reply to Low blood pressure, posted by pretty_paints on August 11, 2005, at 7:41:12
hey! I can undersand drinking coffee because it could help raise your blood-pressure, but there is a big problem: caffeeine tends to increase the level of neuroleptics (old and new, including clozapine) in your blood. This could be good or bad, but if you're experiencing side-effects, its probably not the best approach to take. Cigarette smoking, on the other hand, tends to make neuroleptics (and tricyclic antidepressants) move out of your body unusually quickly, and it also plays with dopamine so that EPS and other side effects are somewhat reduced. THe only antipsychotic I know of that isn't significantly impacted by caffeine and smoking is Abilify...I think that even there, blood levels are affected, but not enough to have any major effects on treatment. If you have low-blood pressure, it seems like some other measures could be taken.... ed_uk will know more, but I think there is a compound used for treatment of hypotension that is chemically induced or naturally-occuring. In sedative overdoses, stimulants are somtimes used, but I don't think that would be the greatest tactic when dealing with neuroleptics. Good luck!
Posted by ed_uk on August 11, 2005, at 17:54:44
In reply to hey!, posted by med_empowered on August 11, 2005, at 17:22:59
Hi Med,
That was an excellent post. Very supportive.
~Ed x
Posted by ed_uk on August 11, 2005, at 17:55:32
In reply to Coffee?, posted by med_empowered on August 11, 2005, at 17:27:37
>If you have low-blood pressure, it seems like some other measures could be taken.... ed_uk will know more, but I think there is a compound used for treatment of hypotension that is chemically induced or naturally-occuring.
Fludrocortisone?
~Ed
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