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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Lindenblüte on October 11, 2006, at 22:38:01
background:
major depression. 6 months on cymbalta 90mg. seroquel 25 mg. provigil 200mg.got out of the major depression. yippee doo.
Started having flashbacks, nightmares, wierd peripheral hallucinations of creepy crawlies. intrusive thoughts. exaggerated startles. strange outbursts of rage, sadness, laughter. out of control emotions seething on the inside. didn't feel safe. started putting pieces together, and working with therapist on trying to understand the extent to which my traumatic childhood is affecting my current situation (lots of conflicts and overwrought emotional reactions affecting many social relationships and also my dreams for the future.) I'm remembering a lot of things and experiencing the terror of being a tiny helpless kid for the first time ever. It's really scary.
the med change
still on cymbalta 90mg
still on provigil 200mg
added klonopin .5 mg am and prn once more during day maybe
seroquel increasing gradually from 50-100-150- 175-200-225 over the course of a week. Tonight I take 250. then we plan to keep me at 300 mg pm.The question I am getting from many babbler is why? The question I wish I had an answer for is: is seroquel making me sad (I've been sobbing uncontrollably for 2 nights in a row, and felt some hints of depression sneaking back in for a few days before that too.)
seroquel dose increase theory:
1) get rid of intrusive thoughts (of my family members abusing me, for instance, or random morbid thoughts, or suicidal thoughts, or of bad things about to happen like in a horror movie)
2) I was still gettting some breakthrough insomnia with 50mg, so, I probably would have gone up to 100 anyways- why not go to a therapeutic dosage?
3) Mood stabilization. seroquel is used as a mood stabilizer for bipolar folks (I don't *think* I'm bipolar, but I've got some unstable moods for sure)
4) potent and fast-acting antidepressant for bipolar folks. http://www.medicalnewstoday.com/medicalnews.php?newsid=32513What do you guys think? The intrusive thoughts are much improved. I'm sleeping like a sandbag. I have been taking naps in the afternoon, but the fatigue has been manageable (((((provigil & coffee)))))
I just have a lot of sadness. My T has been asking me questions about my mom. My mom is someone in my family I still love. But she neglected me. Horribly. And I never acknowledged that. Maybe THAT's why I'm sad?
One complicating factor is that I may be premenstrual. That could be throwing a wrench into the whole mess. Ladies? any experiences with breakthrough depression in PMS phase? Gentlemen, any ideas (experiences with a weepy, enraged lady in your life?)
feelin' not so happy. but 2 days ago was okay. so okay, that I even told pdoc I was doing better. Now what? he's gonna think I'm psycho. Oh. wait. I *AM* psycho.
-Lindenblossom.
Posted by ronaldo on October 12, 2006, at 5:23:27
In reply to Seroquel is making me sadder? or benzos? or life?, posted by Lindenblüte on October 11, 2006, at 22:38:01
Lindenpetal,
Don't know what to make of your meds. Alas I am not a psychopharmocologist. Common sense says the med that you are currently changing should be the one that's altering your mood, so I guess that is the Seroquel. That's the only med I have had any experience with and then only with doses upto 100 mg. Can't say that it made me depressed but working in the greenhouse potting on plants it did give me a few moments of sadness that I could only attribute to the Seroquel.
Maybe you are thinking too much? Try getting out and going somewhere - even if its only a walk round the block. Better still go to a museum or an art gallery or an aquarium or something or indulge in some retail therapy. Maybe you need distraction.
Sitting in front of my keyboard reading about the problems of fellow babblers gets me down some times. I can only take so much suffering and misery and heartache. Psychobabble is some pretty heavy stuff.
Do something different and see if it makes you feel better. ((((((Lindenblüte)))))))
...Alan
Posted by Meri-Tuuli on October 12, 2006, at 8:19:55
In reply to Seroquel is making me sadder? or benzos? or life?, posted by Lindenblüte on October 11, 2006, at 22:38:01
Have you posted a very similar post to that before? I get the feeling that I've read that post before, even twice before. Maybe its deja vu. Strange.
Sorry, I can't comment on your meds...perhaps its just a little dip. Its pretty normal even for normal folks to have little dips and ups. Perhaps you've stopped exercising or perhaps its getting darker.....
Kind regards
Meri
Posted by Lindenblüte on October 12, 2006, at 8:53:50
In reply to Re: Seroquel is making me sadder? or benzos? or life?, posted by ronaldo on October 12, 2006, at 5:23:27
Hi Ronaldo,
thanks for your suggestions. I think you are right about getting out and enjoying life more.I guess I will try to do some life-style modifications and see if I can lift my moods. Just to see the extent to which my meds dampen the enjoyment of activities I usually enjoy.
retail therapy-- um, I've already spent my RT budget for this month. Art supplies (calligraphy) earrings and cosmetics. I do feel happier when I get to play with my new toys :)
I am pretty good about avoiding babble when I know it's going to get me down. I find it kind of soothing to think about other people's problems- gets me out of my own head for a bit. But when the suffering is bad, and I feel like I have nothing to add, I have felt hopeless in the past. That's one danger of babble. Another danger is that we might expect a magic answer to our big problems, but it rarely happens that way. I've been trying to recognize when my expectations are too unrealistic. My T is helping me with that. I'll try to find some new museums/galleries/aquarium/zoo/garden park thing that I haven't been to before. I have a student discount, so many things shouldn't be too expensive. There are a lot of free opportunities that I can take advantage of too.
Thanks Ronaldo :)
-Li
Posted by Lindenblüte on October 12, 2006, at 9:01:51
In reply to Re: Seroquel is making me sadder? or benzos? or li » Lindenblüte, posted by Meri-Tuuli on October 12, 2006, at 8:19:55
Hi Meri-Tuuli-
no, you're right. last week I posted about the med changes that my pdoc and I decided on.
I was hopeful for a few days, and then unhopeful for a few days. now I feel just drained and spacey, but that's how it usually is in the am. It's SOOOO hard to get out of bed after the elephant-tranquilizer sized dose of seroquel. coffee and provigil will kick in after a bit, but my head feels like it's full of porridge.
I hope you're right, that it's just a little dip. I've had a lot of stress and strife recently. I just wish I were more resilient, like I once was.
exercise- I stopped that in April. I need to start again soon. It's getting close to downhill ski season, and my legs are totally mushy. need to do squats, lunges, lots of cardio and some core work. And it IS getting darker. yes.
how about in Finland- what time is it getting dark there? Here it is light from about 7:15-6:30pm.
I'm not sure about these benzos though. maybe I should try just taking a half tablet in the morning and saving the other half for the rest of the day, if needed. The very first time I took it, I felt a fairly obvious effect of mood dampening. Maybe my body has since acclimated to having a .5g dose once in the am, but that might leave me with some kind of "low"
-Li
Posted by Meri-Tuuli on October 12, 2006, at 10:19:28
In reply to Re: Seroquel is making me sadder? or benzos? or li » Meri-Tuuli, posted by Lindenblüte on October 12, 2006, at 9:01:51
Hey L
> I hope you're right, that it's just a little dip. I've had a lot of stress and strife recently.This is a major mood trigger in me at least
> I just wish I were more resilient, like I once was.
I wish I were too!
> how about in Finland- what time is it getting dark there? Here it is light from about 7:15-6:30pm.
It gets dark around 6.30pm now. Its light about 7ish I think. So hardly that dark! :o)
I'm afraid I don't know anything about benzos...I'm from the UK, the most benzo-phobic country on the planet....well for that matter, in the eyes of docs, SSRI/TCAs are the only things that work....well for us 'normal' depression/anxiety folk at any rate.
Kind regards
Meri
Posted by Phillipa on October 12, 2006, at 11:27:45
In reply to Re: Seroquel is making me sadder? or benzos? or li » Meri-Tuuli, posted by Lindenblüte on October 12, 2006, at 9:01:51
Li personally you've amazed me at the speed of pdocs, therapists, dissertations, husband away. Maybe it's too much all at once. And I'd call the pdoc and find out why he wants you on such a hight dose of seroquel. And maybe if you're close with your T inform her and ask her advise of what she thinks might help. I agree with Ronaldo that's a heavy dose of seroquel. Love Phillipa ps well you know where I am
Posted by Lindenblüte on October 12, 2006, at 11:43:20
In reply to Re: Seroquel is making me sadder? or benzos? or li » Lindenblüte, posted by Phillipa on October 12, 2006, at 11:27:45
Phillipa,
I typically don't move that fast. Dissertation work takes up about 2-3 hours a day, on a GOOD DAY! School & work meetings and such are often stressful, and I've been doing my best to limit my responsibility to participate and attend them. Right now I'm still making a transition between summer work-load and semester work-load. It's a tricky balancing act.To tell you the truth, the last 2 days were indeed too too much. I can recognize that now. I should have been kinder to myself, and avoided unnecessary drama. This is one of my problems though-- I tend to create too much drama and expose myself to excess stress at precisely the times when I ought to be cruising and taking it easy.
I know exactly why the pdoc wants me on a high dose of seroquel. It is so that I will stop having so many intrusive thoughts and mood swings. Also to augment my cymbalta. It's not that high anyways. Many people take it at doses up to 600-800 mg to get antipsychotic benefits. Remember how Scott told you that doses like 200mg were the type that were likely to have antidepressant effects?
I'm feeling a little better today. A lot of it is because I have a clear schedule. More freedom to do what I want, when I want it. I am also looking forward to having my girlfriends over to watch Grey's Anatomy. I will cook them dinner, and vacuum my place (I cleaned it already on tuesday). I am looking forward to this a lot.
I'm gonna take it easy for now. Do some stuff that doesn't require heavy brain power. I have some nice classical music on my headphones and no stressful appts or deadlines coming up until next week yay.
I see my T this afternoon. You bet I will tell her that I had a really rough couple of days.
Thanks for thinking of me. It's nice to feel that you care for me :) and yes, I do know where you are :) How come you never go to babble-chat? just curious
-Li
Posted by Phillipa on October 12, 2006, at 12:08:05
In reply to Re: Seroquel is making me sadder? or benzos? or li » Phillipa, posted by Lindenblüte on October 12, 2006, at 11:43:20
Li don't know how it works . Tried once. I'm glad you're taking it easy today. Love Phillipa
Posted by Phillipa on October 12, 2006, at 19:34:30
In reply to Re: Seroquel is making me sadder? or benzos? or li » Phillipa, posted by Lindenblüte on October 12, 2006, at 11:43:20
I googled seroquel and could find nothing on it being good for depression. Anxiety yes. Depression no. Anyone have a link? Love Phillipa ps I'd feel better if I could read it.
Posted by Jost on October 12, 2006, at 21:34:43
In reply to Seroquel is making me sadder? or benzos? or life?, posted by Lindenblüte on October 11, 2006, at 22:38:01
Seems like AstraZeneca is exploring use of seroquel for bipolar depression and some other more treatment resistant mood disorders.
Could also help with depression-- but it's more focussed on bipolar I and II.
However, the dosing is pretty individually tailored, so how did your Pdoc decide on 300 mg?
Maybe you could reduce the dose temporarily, and see how that affects things. If you feel better, and your mood and intrusive thoughts are okay, great-- if you need more, you could increase dosage more slowly to minimize the exhaustion. Unless you need it more urgently--- for the thoughts. Then maybe it's worth the temporary blur. Sometimes, that's almost helpful, to get you away from the pain and loss. IMExperience, anyway.
Though, Linden, it could be that talking about disappointment in your mother, rather than meds, is causing a lot of sadness now. It's hard to think about your "good" parent and try to come to terms with the loss of some of the intensity of what may be an idealization of them-- to help survive in early times.
At least in the short-term, while you're feeling some of the neglect or lack of empathy that you experience with your mother, you might lose touch with the sense of her goodness---or good-enoughness-- but be able to refind it, in a clearer and more realistic, and loving way, later.
You've been though so much lately. Hope your evening was carefree and fun. I heard McDreamy and one of the other Drs. had "words" on the set? IRL, that is.
Jost
Posted by alexandra_k on October 13, 2006, at 1:06:38
In reply to Re: Seroquel is making me sadder? or benzos? or li, posted by Jost on October 12, 2006, at 21:34:43
i think that is a good idea about reducing the benzos.
seroquel... will zonk you / make you feel tired and lethargic while your body is getting used to it.
the sadness...
you said you felt sad after the benzo high wore off (the first time you took it) so maybe the benzo's are having a paradoxical effect.
they do that sometimes...
give them to people for rage and sometimes the benzos increase the rage rather than calming them down.
give them to people for anxiety and sometimes they increase that.
give them to people for depression and well...
just my 2c.
it is of course impossible to know whether it is the seroquel or the benzo since they both changed at the same time.
it isn't uncommon for a p-doc to do something like that when the person presents fairly distressed... they just want to do something anything to help...
i hope you feel better soon.
Posted by UgottaHaveHope on October 13, 2006, at 3:09:56
In reply to Seroquel is making me sadder? or benzos? or life?, posted by Lindenblüte on October 11, 2006, at 22:38:01
OK, hear me out on this: I take Seroquel too. Here's my theory: It makes you more tired, which makes you less active, which makes you feel bad about not being active, which makes me feel sad. But you've got to fight it. Seroquel is a miracle drug for sleep. Perhaps you should take less of it, or even counter it with caffeine during the day.
Posted by Lindenblüte on October 13, 2006, at 11:03:52
In reply to Re: Seroquel could make you less active, not sad, posted by UgottaHaveHope on October 13, 2006, at 3:09:56
> OK, hear me out on this: I take Seroquel too. Here's my theory: It makes you more tired, which makes you less active, which makes you feel bad about not being active, which makes me feel sad. But you've got to fight it. Seroquel is a miracle drug for sleep. Perhaps you should take less of it, or even counter it with caffeine during the day.
Oh yes, definitely makes me more tired and sedated. and this can impact my productivity, and make me feel depressed about not getting my work done during the day. You are VERY right about this. My AD (cymbalta) also makes me quite tired during the day, even after taking it for several months now (90mg).
For these reasons, I have been taking provigil, 200mg every morning, and I have caffeine (usually coffee or black tea) in the am, and also some caffeine at lunch time). I feel pretty awake, am doing fairly well in terms of concentrating. I get an energy slump between 4-8pm, and then feel great- I could stay up later, but I take my meds at about 10 pm every night. I have a very regular sleep cycle. always in bed by 11-12, always awake between 7-8am.
Thanks for your suggestions though. On the occasions where I have forgotten to take provigil, or I didn't get my Rx filled for a few days, I was feeling like a complete lump, and a drag, and getting whiny and mopey, so yes- you are ABSOLUTELY right that energy level can dramatically affect mood.
thanks!
-Li
Posted by Lindenblüte on October 13, 2006, at 11:06:49
In reply to Re: Seroquel is making me sadder? or benzos? or li » Lindenblüte, posted by Phillipa on October 12, 2006, at 19:34:30
http://www.medicalnewstoday.com/medicalnews.php?newsid=32513
Hi Phillipa,
I posted this once above, but maybe it got lost?Anyways- my pdoc says that an AD dose is closer to 300 mg for me, which is also what the study used.
enjoy!
-Li
Posted by Lindenblüte on October 13, 2006, at 12:27:39
In reply to Re: Seroquel could make you less active, not sad » UgottaHaveHope, posted by Lindenblüte on October 13, 2006, at 11:03:52
Causes of Li's sadness: an interdependent web of neuroendocrinology, psychopharmacology, current and past life stressors & psychotherapy.
1) PMS makes me confrontational and bitchy. Indeed, as suspected I WAS premenstrual. This exacerbated stress in my phone conversations with husband who is away. Hour-long unresolved disagreements create stress and sadness, especially when the disagreement is with someone I usually turn to for help, comfort & love.
2) Three days in a row of solid-packed meetings, and somehow I had to do a lot of complicated data analysis too. I ended up bringing laptop to meetings and working on the dataset then. I actually had to resort to HOMEWORK
3) Pdoc started me off on a brand new medicine (Klonopin) at a fairly high dose (I think?) .5mg 2x a day and 1 extra prn -which I didn't take. I was nervous about taking this drug, but I wanted to give it a shot. I tend to be fairly sensitive to meds, especially new ones. I felt kind of loopy and uncoordinated, and had trouble focusing, and felt a touch groggy and down, at least for the first few days of this. Then we decreased my dose to .5mg am only, and prn one more during the day. This was better, but by this time I was PMS!
4) Hard to balance med changes that affect things like energy level and concentration and memory when my work load was high and needed special super-human abilities to remember which data had been entered, and checking for mistakes.
5) On Monday night, I had a really bad dream about my mom having strong denial against my ever being abused. On Tuesday, me and T started talking about my mom for the first time. I was feeling sad because my psychotherapist had a really sad look on her face when I told her about how my mom used to forget to pick me up after school. The thing is that when I tell my T about some of the events in my childhood, she shows emotions on her face, like sadness, or empathy, or outrage and I never actually realized that these events could evoke emotions. Now, I can see my T's face in my mind, and seeing her sad about this makes me feel sad about some aspects of my parents' behavior that I just accepted before. I was floating through the last few days with an overwhelming undercurrent of grief, and trying to manage to do everything else with what little mind I could manage to spare.
so. sadness is complicated. The good news is that I feel less sad today.
1) PMS symptoms largely abated.
2) work scheduled is open and easy
3) staying away from difficult people
4) had a nice social event with my friends last night
5) starting to get used to the dosing of seroquel (I'm on 275 mg now)
6) kind of acclimating to the klonopin funny feeling
7) TGIF
8) I'm getting my hair cut today- my favorite stylist has an opening, and it's the only day I have available for 4 weeks!!!
9) nice babble people give me good ideas about understanding my sadness.
10) me and husband are having normal conversations again, and he gave me a phone kiss :)-Li
Posted by willyee on October 13, 2006, at 19:10:09
In reply to Seroquel as Antidepressant. Study Abstract Link, posted by Lindenblüte on October 13, 2006, at 11:06:49
> http://www.medicalnewstoday.com/medicalnews.php?newsid=32513
>
> Hi Phillipa,
> I posted this once above, but maybe it got lost?
>
> Anyways- my pdoc says that an AD dose is closer to 300 mg for me, which is also what the study used.
>
> enjoy!
> -Li
I could have been in this study lol,coolness.
Posted by dreamboat_annie on October 14, 2006, at 0:36:53
In reply to Seroquel is making me sadder? or benzos? or life?, posted by Lindenblüte on October 11, 2006, at 22:38:01
Could be the Klonopin. It made me feel depressed when I tried it. I took it for about a week (and the dose was very small), and by the end of the week I was noticeably depressed and lethargic. I'm a Xanax girl. Never had a problem with it and it doesn't make me groggy or tired or depressed. It almost picks me up when I take it, although I don't use it daily and sometimes, now anyway, only use it a few times a month.
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