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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 UgottaHaveHOPE on May 24, 2006, at 20:03:24
I was taking 200mg Seroquel, 3-4 mg Klonopin, and 20 mg Paxil for anxiety and depression.
She boosted me up to 400mg of Seroquel, 40 mg of Paxil and 3-4 mg Klonopin.
What do you think? She said she was going to keep me boosted until I could calm down and then reduce some of the meds. Could be weeks or months.
Posted by Phillipa on May 24, 2006, at 20:26:10
In reply to Went to pdoc today and here's what she said?, posted by UgottaHaveHOPE on May 24, 2006, at 20:03:24
Michael we're all different. Sounds like it should be fairly quick since she doubled everything. Keep us posted okay? Love Phillipa
Posted by UgottaHaveHope on May 25, 2006, at 0:13:18
In reply to Re: Went to pdoc today and here's what she said? » UgottaHaveHOPE, posted by Phillipa on May 24, 2006, at 20:26:10
read 1st post
Posted by yxibow on May 25, 2006, at 2:32:11
In reply to Went to pdoc today and here's what she said?, posted by UgottaHaveHOPE on May 24, 2006, at 20:03:24
> I was taking 200mg Seroquel, 3-4 mg Klonopin, and 20 mg Paxil for anxiety and depression.
>
> She boosted me up to 400mg of Seroquel, 40 mg of Paxil and 3-4 mg Klonopin.
>
> What do you think? She said she was going to keep me boosted until I could calm down and then reduce some of the meds. Could be weeks or months.
We never know how long things will take in a medication plan. As my doctor says, he's a psychologist, not a psychic.
As for the "calm down", I assume you're experiencing some severe anxiety and depression. Seroquel or similar antipsychotics are frequently used to boost SSRIs. 400mg is considered a "clinical dose" for Seroquel alone. Whether it is more or less than you ultimately need as an augmentation to Paxil is another story.
Paxil is, next to Luvox, one of the more calming and sedating SSRIs for most people, and thus is a choice for use in patients who have anxiety and depression. Because I know I've been on SSRIs before, and they can be marvelous for one or the other but not often both. That's probably also where the Klonopin comes in. You are at a fairly substantial but by no means unheard of dose of Klonopin. As long as you are aware of the road and safe with your plan, it doesn't sound like a major increase. If you begin to become too somnolent, alert your doctor -- maybe it will become too much. Antipsychotics are fairly fast acting so I think that your plan with an increased dose may not be for that long of a time. Seroquel is the weakest of all the antipsychotics, but as I know personally and understand, it is also drowsy making.
Best luck with your plan and continue to communicate with your doctor exactly how you feel. I see a fair number of postings of "after the fact" meetings. I understand that not everyone is abreast in all the intricacies of medications -- after all thats why you're visiting a doctor. But sometimes I think that people should have more of a collaborative relationship. Write down things on a notepad if you need to. Take them in. Ask your doctor why X, Y, and Z is needed if you have questions. Then a treatment plan I think works much better.-- Best wishes
Jay
Posted by bassman on May 25, 2006, at 7:22:01
In reply to Re: Went to pdoc today and here's what she said? » UgottaHaveHOPE, posted by yxibow on May 25, 2006, at 2:32:11
Really good advice on the collaborate with your doc...otherwise, you sort of feel like you're getting the Mystery Pill of the month. I've done that and it hasn't worked well. Fortunately, this board provides knowledgable people like yxibow and others to at least raise a red flag if something really foolish is being suggested-and I wish I could say that never happens.
When I was taking Paxil for panic disorder, I found it powerfully stimulating and I'm taking Prozac now and find it sedating-and I know it's supposed to be the other way around. It's amazing how people respond to meds so differently...I wonder if just such information says something that would be useful clinically; that is, "oh, you are stimilated by Paxil but sedated by Prozac, unaffected in any way by Zoloft, and made fearful by Wellbutrin?-well, then that means..."
Posted by SLS on May 25, 2006, at 7:44:54
In reply to Re: Blueberry, Yxibow, SLS???????????, posted by UgottaHaveHope on May 25, 2006, at 0:13:18
> read 1st post
"If you throw enough crap against the wall, some of it is bound to stick."
Sometimes, this approach makes sense. I don't find fault with your doctor's instructions. For now, it doesn't really matter whether or not you can identify which components of your treatment are needed and which ones are not. You need relief as soon as possible.
I am still thinking that Depakote might be the right drug for you. It's just a guess, though.
- Scott
Posted by bassman on May 25, 2006, at 7:57:28
In reply to Re: Blueberry, Yxibow, SLS???????????, posted by SLS on May 25, 2006, at 7:44:54
Can you imagine that in a medical book for pdocs: "choosing a proper medication protocol for a patient is like throwing crap against a wall and seeing if some of it sticks" (I'm SO much more optimist about it; I think of it as an Easter Egg Hunt :>}). The funny thing is...
Posted by tessellated on May 26, 2006, at 13:13:31
In reply to Re: Blueberry, Yxibow, SLS???????????, posted by SLS on May 25, 2006, at 7:44:54
Personally, I think that a rather drastic line up.
Mostly in regard to the seroquel.
It is in my experience another zombie pill, with similar though more mild anti-dopamine affects-yet predominantly unpleasant. I don't like antagonists like that, nor the use of anti-psychotics for anxiety.I agree, depakote i've seen to be quite successful, and its action enhances GABA.
I think seroquel is just safe.
It is THE NEWEST WONDER DRUG in all inpatient programs.
Expensive as all hell, and basically makes people hungry and controllable, and sedated in a "mind fogging" way.Again, for mania/psychosis yeah sure first line, but anxiety/depression? OVERKILL.
IMHO,
tessellated
Posted by yxibow on May 27, 2006, at 1:02:35
In reply to Re: Blueberry, Yxibow, SLS???????????, posted by tessellated on May 26, 2006, at 13:13:31
> I think seroquel is just safe.
> It is THE NEWEST WONDER DRUG in all inpatient programs.
> Expensive as all hell, and basically makes people hungry and controllable, and sedated in a "mind fogging" way.
>
> Again, for mania/psychosis yeah sure first line, but anxiety/depression? OVERKILL.
I take it only for its intricacies at D2 (I am not psychotic by any means -- if I was it would be a blessing in disguise because my disorder wouldn't be so hurting inside, I wouldn't know I had one) -- it would take a lot of explanation, but it is the only anti-dopinaminergic drug out there that might provide some relief for a very complex Somatiform/PTSD/OC Spectrum disorder, that doesn't tear you apart. It is a very weak neuroleptic and is much safer than previous ones -- not to say I haven't had odd side effects.But I do agree that neuroleptic medication for simple anxiety disorders may not be the first line of defense.
Antagonists are just a different method of putting transmitter levels in check. Remeron is a partial antagonist at 5HT2, as well as being an alpha-adrenergic medication.
I feel no more "controllable" on Seroquel than I felt on any SSRI or other psychotropic. I am in very much command of my intellect, so I do take issue with that. Sedated in a "mind fogging way", I will agree -- but that isn't just Seroquel, all neuroleptics have an unfortunate side effect known as "blunting." It means your affect -- your emotions, ability to cry, are dampened or as I've experienced, delayed. This can be a good thing in some situations, it helps keep frightening situations in check, but at the expense that "letting it all out" may come at a later moment. Hungry -- mm... a bit.... and yes, it does affect lipid profiles, but it doesn't like Zyprexa, which I would take if it didnt cause incessant handshaking. But I regularly go to the gym, primarily to remove the weight I gained on Remeron, and I'm making quite a good progress on it. My cholesterol dropped to my college days, which was actually slightly below normal -- just from excercise, which is true, for anyone.
-- tidingsJay
This is the end of the thread.
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