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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by fairywings on September 12, 2005, at 11:55:34
Hi Scott,
I was just wondering what you thought of this med combo, i don't know the dosages, but B2chica is suicidally depressed, and i think it's the meds (of course the alcohol doesn't help), but what do you think?
ritalin, wellbutrin, zyprexa and xanax (ambien and gin and tonic as needed)
fairywings
Posted by SLS on September 12, 2005, at 15:12:32
In reply to Scott/SLS? ****trigger*****, posted by fairywings on September 12, 2005, at 11:55:34
Hi FW.
> I was just wondering what you thought of this med combo, i don't know the dosages, but B2chica is suicidally depressed, and i think it's the meds (of course the alcohol doesn't help), but what do you think?
> ritalin, wellbutrin, zyprexa and xanax (ambien and gin and tonic as needed)
It sounds like she is self-medicating in an effort to relieve herself of anxiety. Both Ritalin and Wellbutrin can cause anxiety, which can act to propel a depressed person into a suicidal state. Wellbutrin made me feel more depressed, even though it did not produce anxiety. It intensified my dysphoria. It is difficult to guess with 100% certainty what exactly is going on here. What is she being treated for, and why were these drugs chosen for her in the first place? I am particularly interested in the Ritalin and Zyprexa.
- Scott
Posted by zeugma on September 12, 2005, at 15:57:09
In reply to Re: Scott/SLS? ****trigger*****, posted by SLS on September 12, 2005, at 15:12:32
Hi, just to add to what Scott said:
I have seen someone become severely dysphoric on Wellbutrin. It was not the sight of someone relapsing into depression, but a drug-induced dysphoria.
I myself never found Ritalin to be a 'depressing' drug per se, but it does cause emotional intensification (for me), which tends to exaggerate feelings for better or worse.
-z
Posted by fairywings on September 12, 2005, at 16:58:25
In reply to Re: Scott/SLS? ****trigger*****, posted by SLS on September 12, 2005, at 15:12:32
>
> It sounds like she is self-medicating in an effort to relieve herself of anxiety. Both Ritalin and Wellbutrin can cause anxiety, which can act to propel a depressed person into a suicidal state. Wellbutrin made me feel more depressed, even though it did not produce anxiety. It intensified my dysphoria. It is difficult to guess with 100% certainty what exactly is going on here. What is she being treated for, and why were these drugs chosen for her in the first place? I am particularly interested in the Ritalin and Zyprexa.
>
>
Hi Scott,She is dx'd as borderline, if i'm not mistaken from what she's said in her posts, but i do think there's been a little back and forth on that. i have had depression with both adderall and strattera, so i can see depression with wellbutrin as well. i don't know why those particular drugs were chosen, i will ask her, and see what she says. she's going to see her T tonight, and hope she will call her p-doc.
i will try to post her with your info. and thanks for getting back to me.fw
Posted by fairywings on September 12, 2005, at 16:59:46
In reply to Re: Scott/SLS? ****trigger*****, posted by zeugma on September 12, 2005, at 15:57:09
thank zeugma, will be sure to send this to her so she will know that it might not be her.
thanks
Posted by B2chica on September 14, 2005, at 11:13:18
In reply to Re: Scott/SLS? ****trigger*****, posted by SLS on September 12, 2005, at 15:12:32
> > I was just wondering what you thought of this med combo, i don't know the dosages, but B2chica is suicidally depressed, and i think it's the meds (of course the alcohol doesn't help), but what do you think?
>
> > ritalin, wellbutrin, zyprexa and xanax (ambien and gin and tonic as needed)
>
> It sounds like she is self-medicating in an effort to relieve herself of anxiety. Both Ritalin and Wellbutrin can cause anxiety, which can act to propel a depressed person into a suicidal state. Wellbutrin made me feel more depressed, even though it did not produce anxiety. It intensified my dysphoria. It is difficult to guess with 100% certainty what exactly is going on here. What is she being treated for, and why were these drugs chosen for her in the first place? I am particularly interested in the Ritalin and Zyprexa.
> - Scott
Hi Scott.
yes, i'm certainly self-medicating. from the minute i get home from work i want to just go to sleep and wish the day would just end.
i haven't been drinking the last week since my S. ideation is so strong. and am so close to acting i don't need that extra push.i'm on ritalinLA @20mg for depression and ADD, wellbutrin 300mg for depression, zyprexa @10mg for dysphoric mania? and xanax @2mg for anxiety and sleep, ambien 10-20mg PRN for sleep.
this combo used to work but i;ve had several stressors in my life lately and i'm sure are contributing.
i'm Dx with bipolar, add, ptsd, anxiety and some ocd. both my docs before were not completely convinced i was bipolar because of how the mania/euphoric and dyphoric were appearing, my T says i have schiotypal and some schizoid personality traits. thus the zyprexa?? at least once when i was in the hospital i had one of my little 'episodes' and right away they put me on zyprexa. it works but i gained 23 lbs on it. ;(about the suicide, i'm really afraid of myself...what i hear in my head is that "i'm going to kill myself it's just a matter of when". i have the means motive and isolated location. that's why i'm probably headed back to the hospital, which causes more anxiety and more s.ideation.
i called my pdoc yesterday and he said to go to his office and pick up samples over my noon hour (extra 150 of wellbutrin), which puts me at 450mg. but he too was VERY concerned about how calm i was about the suicidal thoughts. he wanted me to go in yesterday cuz he said it's not enough time to let the meds work. so i'll probably end up back there thurs. after my T appt.
thanks for any insight to medication combo.
btw i've been on many meds before:
prozac (terrible!)
effexor (terrible!)
trileptal
risperdal
lamictal
strattera
seroquel
trazadone
symbyax
sonata
and maybe more that i forgot.anyway, this time around i've really been working hard to get through. doing exactly what people say no matter how corny, i've been walking, doing housework, getting outside, going to the libraries, going into work ANYthing to distract me and wade through this. it's not going away. i just end up feeling exhausted like walking up hill against a 100 mph wind.
i know my method is a sure fire way to make S. happen.i just need protection right now.
thanks for listening.
b2c.
Posted by fairywings on September 14, 2005, at 13:21:05
In reply to Re: Scott/SLS? ****TRIGGER***** » SLS, posted by B2chica on September 14, 2005, at 11:13:18
Hey B2, just out of curiosity, what did the Strattera do for/to you? I was on it too, and want to compare notes. I went from 40 mg. wk one to 80 mg. week 2, and week 2 had similar suicidal thoughts on it that you're having now.
I hate to keep saying the same thing, but you know when you've tried something and it's been bad, and then you see someone else on the same thing, and they feel like crap, well, you know....
fw
Posted by SLS on September 15, 2005, at 16:34:26
In reply to Re: Scott/SLS? ****TRIGGER***** » SLS, posted by B2chica on September 14, 2005, at 11:13:18
Hi there!
> yes, i'm certainly self-medicating. from the minute i get home from work i want to just go to sleep and wish the day would just end.
Sometimes the clock just doesn't move fast enough.
> i haven't been drinking the last week since my S. ideation is so strong. and am so close to acting i don't need that extra push.
For immediate relief, you could either try bringing your Zyprexa up to 20mg or add Risperdal or Seroquel temporarily. I'm sure each doctor will have his preference on how to deal with the situation. How did you respond to Risperdal?
> i'm on ritalinLA @20mg for depression and ADD, wellbutrin 300mg for depression, zyprexa @10mg for dysphoric mania? and xanax @2mg for anxiety and sleep, ambien 10-20mg PRN for sleep.
> this combo used to work but i;ve had several stressors in my life lately and i'm sure are contributing.
Yes. This phenomenon is known as "medication breakthrough" wherein an increase in psychosocial stress causes the illness to penetrate through the medication and produce symptoms. Doctors often increase the dosage of medication temporarily in situations like this.
> i'm Dx with bipolar, add, ptsd, anxiety and some ocd. both my docs before were not completely convinced i was bipolar because of how the mania/euphoric and dyphoric were appearing, my T says i have schiotypal and some schizoid personality traits. thus the zyprexa??
The Zyprexa is probably there to combat the presumed bipolar symptoms of mania and mixed states (dysphoric mania). Schizotypal personality is not really translatable into an Axis I disorder (major depression, bipolar disorder, schizophrenia, OCD, generalized anxiety disorder, etc.) and does not determine illness-specific medication.
> at least once when i was in the hospital i had one of my little 'episodes' and right away they put me on zyprexa. it works but i gained 23 lbs on it. ;(
What exactly are your "little episodes"?
Have you been screened for borderline personality disorder (BPD)?
> about the suicide, i'm really afraid of myself...
You should be.
This is a healthy and rational fear. Please continue to take measures to treat it as the crisis that it is.
> what i hear in my head is that "i'm going to kill myself it's just a matter of when".
I understand this. I have been there before. I may be there again one day.
I don't know what to say.
You probably have several rational reasons for wanting to end the pain. However, know that it is not necessary to end life in order to end pain, despite how your past history might make you feel otherwise. Depression is a liar. In fact, it can make one feel suicidal despite having no painful history at all. When you feel suicidal, be sure to remind yourself of this. Depression is distorting your thinking and influencing negatively your outlook.
Recall that you said that things had been working up until recently:
"this combo used to work but i;ve had several stressors in my life lately and i'm sure are contributing."
Prior to your medication breakthrough, how were you feeling? Had you been at all happy with your life?
> i have the means motive and isolated location. that's why i'm probably headed back to the hospital, which causes more anxiety and more s.ideation.
Here's the deal: Anxiety is a primary contributor to suicidal states. It is extremely important to treat the anxiety acutely - like right now. Adjustments in antidepressants might take too long to make a difference. That is why I thought it might be a good idea to try adding Risperdal or Seroquel or increase the Zyprexa temporarily. Let the doctors do their thing.
Try to keep your outlook positive in that temporary hospitalization can be healthy and constructive. It can be a respite from stress and a milieu within which you can learn to deal with the stresses in your life more efficiently.
If you must avoid hospitalization to remain employed, I can understand your anxiety and apprehension. In this case, you might want to work more closely with your doctor to address the anxiety compontent of your depression immediately so that you have a chance of avoiding hospitalization. I will be very interested to know how your doctors address your suicidogenic anxiety.
Depression is a liar. Don't make life and death decisions based upon the warped messages it sends you.
- Scott
Posted by B2chica on September 19, 2005, at 12:21:34
In reply to Re: Scott/SLS? ****TRIGGER***** » B2chica, posted by SLS on September 15, 2005, at 16:34:26
thanks for the responses SLS.
-yes i think i have heard of the medication breakthrough, but when stress relieves, i could go back down dosage right?
-yes the zyprexa was originally given (2 years ago) for 'hypomanic episodes'.
i understand that schizotypal PD is axis 2, but my doc has casually brought up schizophrenia a couple times, i never flat out asked him, and really don't want to know at this point but i mentioned it cuz my 'episodes' are similar to that (at least thats what the nurses told me and that's why the pdoc in the hospital put me on zyprexa. My ocd goes haywire and i have to repeat words over and over until it's enough and lands on an even number. i have a string of sentences going on in my head and their overlapping eachother and that makes it very hard to talk, it gets so loud in there. in the hospital i started getting caught up in a formula that i created and started writing everything in binary code, it hurt to hear others talk cuz it interrupted my focus on getting all the sounds, words, string of sentences out of my head. i have this song that helps me when i'm at my worst. it's spinning plates by radiohead. if you've ever heard that song, That's what it sounds like in my head...really listen to all the different harmonics going on, there's so much that it's like it keeps those hundreds of secctions of my brain busy so that i can somewhat comprehend what is going on around me. The anxiety is So high also....this can last up to about two or so hours at the most (but typically hour/hourand half at it's highest peak, then i crash and i mean physically i collapse and can't move for about two-three hours i'm so drained.they used to have me in BPD cuz of my cutting, but i think my t took that away and prominantly put me as mainly PTSD.
>>Depression is a liar. Don't make life and death decisions based upon the warped messages it sends you.REALLY like this saying. i'll need to remember this.
thanks for the help scott.
b2c.
Posted by SLS on September 20, 2005, at 23:30:21
In reply to Re: Scott/SLS? ****TRIGGER***** » SLS, posted by B2chica on September 19, 2005, at 12:21:34
Hi.
> -yes the zyprexa was originally given (2 years ago) for 'hypomanic episodes'.
Has schizoaffective disorder been ruled-out?
Axis II disorders are outside my scope of knowledge.
How much Zyprexa are you taking now?
> i have a string of sentences going on in my head and their overlapping eachother and that makes it very hard to talk, it gets so loud in there. in the hospital i started getting caught up in a formula that i created and started writing everything in binary code, it hurt to hear others talk cuz it interrupted my focus on getting all the sounds, words, string of sentences out of my head.
It might be worth looking into using perphenazine (Trilafon). It is an older antipsychotic that might help you "filter" out the "noise" in your head so that you can focus better. Risperdal would be another consideration. In addition to being an antipsychotic, it also seems to help with OCD.
I'm sorry you are having such a difficult time organizing your thoughts without the constant interruptions and OCD rituals. Please keep posting here. It might help to have the added support of the community here and also to create a journal that might offer you some sense of continuity.
Good luck.
- Scott
Posted by B2chica on September 21, 2005, at 9:30:50
In reply to Re: Scott/SLS? ****TRIGGER***** » B2chica, posted by SLS on September 20, 2005, at 23:30:21
thanks for the suggestion Scott. i don't think SA has been ruled out, infact i've actually read up on it and it sounds like it could fit me. is schizoaffective Axis 1 or 2? did i forget to mention i started to make up my own language?...only have about three pages of words but since i've been on zyprexa the ideas are GONE.
i'm at 10mg zyprexa, but my problem is i can't seem to take it regularly, i forget, or i remember too late at night (makes for getting up hard) so i skip, and the less i take it the stronger i feel NOT to take it...it's really my own d@mn fault. if i take it regularly i think i'd be fine.
oh, i have tried risperdal up to 2mg but it didn't really even touch any of those things so he took me off it.ya, i love this place, i've been here almost 2 years now, mostly this year i've been on psychology-sorting out cr@p.
but peak at medical and writing boards now and again.again, thanks for the info Scott.
b2c.
This is the end of the thread.
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