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Dr. Bob is Robert Hsiung, MD,
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Posted by Sheilac on September 30, 2014, at 5:51:23
In reply to Re: Lou's reply-- thabrkenrowd » Lou Pilder, posted by Phillipa on September 29, 2014, at 22:25:32
I just don't know what to do. I'm shaking so bad I can't stand it. The on call shrink was of no help. He said Elavil does that and to either deal with the neuropathy or the shaking.
But I really think the Geodon isn't helping. I'm desperate.
I feel like I need a mood stabilizer.
I'm not sleeping well either.
I have Depakote and Trileptal. I really think I need to wean off Geodon and immediately add a mood stabilizer. I can't wait 2 weeks.
So far this morning I took 2mg Klonopin and 100mg Atarax.
I need something quick.
I don't think going higher on Geodon is the answer. I think it might make things worse.
I think the antidepressant is making me hypomanic.
Any suggestions as to how to make it 2 more weeks?
Posted by Christ_empowered on September 30, 2014, at 6:13:49
In reply to Depakote + Elavil ?!, posted by Sheilac on September 30, 2014, at 5:51:23
can't you take lyrica or Neurontin for the neuropathy? maybe ultram?
Posted by Sheilac on September 30, 2014, at 6:19:40
In reply to Re: Depakote + Elavil ?!, posted by Christ_empowered on September 30, 2014, at 6:13:49
I have ultram and it helps but not completely.
I failed neurontin and Lyrica. Elavil is the only thing that's brought me relief.
But I'm jumping out of my skin. I feel like the Geodon don't the best mood stabilizer at this point.
Maybe I'm getting too much serotonin or I'm just hypomanic.
That's why I thought the Depakote or Trileptal would help.
I hate feeling this way.
Posted by Lou Pilder on September 30, 2014, at 6:27:03
In reply to Depakote + Elavil ?!, posted by Sheilac on September 30, 2014, at 5:51:23
> I just don't know what to do. I'm shaking so bad I can't stand it. The on call shrink was of no help. He said Elavil does that and to either deal with the neuropathy or the shaking.
>
> But I really think the Geodon isn't helping. I'm desperate.
>
> I feel like I need a mood stabilizer.
>
> I'm not sleeping well either.
>
> I have Depakote and Trileptal. I really think I need to wean off Geodon and immediately add a mood stabilizer. I can't wait 2 weeks.
>
> So far this morning I took 2mg Klonopin and 100mg Atarax.
>
> I need something quick.
>
> I don't think going higher on Geodon is the answer. I think it might make things worse.
>
> I think the antidepressant is making me hypomanic.
>
> Any suggestions as to how to make it 2 more weeks?S,
You wrote,[...I just don't know what to do...I'm desperate...I need something quick...any suggestions...]
The addition of the two drugs could cause confusion and also create another increase in the chances of heart failure and death. The impairment of your thinking that the additional drugs could cause, makes the probability of death even more likely in these two weeks that you need.
I question as to if one in the condition that you are in is competent to make your own decisions to make it the two weeks. This is because the drugs themselves can cause impaired thinking and gross confusion even to the point of committing suicide or adding a drug that you may have shelved years ago that could cause death. This is because the combination of these drugs can create an exponential effect to the point that one can have suicidal and/or homicidal thinking induced into them exacerbated by what you describe as shaking, which could be akathesia that can cause desperation. It is this state of desperation that you include here that can cause one to do things that they think will be OK, not knowing that they could be killed by doing it, such as driving while in this state.
I am prevented here by the prohibitions posted to me by Mr Hsiung to lead you out of the desperation that you describe.
Lou
Posted by Sheilac on September 30, 2014, at 6:40:28
In reply to Lou's response-shrinknohelp » Sheilac, posted by Lou Pilder on September 30, 2014, at 6:27:03
I don't feel mentally imparted or suicidal. I just know my body and it is super shaky and hypomanic.
My thinking (as well as my pharmacist) is that maybe I'm getting hypomania from the combo of Geodon & Elavil.
I'm just saying I think I need to taper the Geodon and take a mood stabilizer.
Not sure which one would help the fastest at this point. Depakote or Trileptal.
Posted by Lou Pilder on September 30, 2014, at 7:15:28
In reply to Re: Lou's response-shrinknohelp » Lou Pilder, posted by Sheilac on September 30, 2014, at 6:40:28
> I don't feel mentally imparted or suicidal. I just know my body and it is super shaky and hypomanic.
>
> My thinking (as well as my pharmacist) is that maybe I'm getting hypomania from the combo of Geodon & Elavil.
>
> I'm just saying I think I need to taper the Geodon and take a mood stabilizer.
>
> Not sure which one would help the fastest at this point. Depakote or Trileptal.
>
> S,
I question as to how one could self-prescribe mind-altering drugs, if that is what you are doing. If they have them on hand from previous uses, they could be contaminated. But worse, taking the un prescribed drug could cause death because of the interaction between the drugs being prescribed may not be known by the self-prescriber.
Lou
Posted by Sheilac on September 30, 2014, at 7:43:27
In reply to Lou's reply-pselphprescibe » Sheilac, posted by Lou Pilder on September 30, 2014, at 7:15:28
I know both depakote and Trileptal work to put out the hypomania fire. Geodon & elavil are causing hypomania.
It makes sense to me to wean off Geodon and add a true mood stabilizer. Unless upping the Geodon is an option, which I think it's not.
This seems simple to me. I just don't know what to do.
Posted by Lou Pilder on September 30, 2014, at 7:57:28
In reply to Re: Lou's reply-pselphprescibe, posted by Sheilac on September 30, 2014, at 7:43:27
> I know both depakote and Trileptal work to put out the hypomania fire. Geodon & elavil are causing hypomania.
>
> It makes sense to me to wean off Geodon and add a true mood stabilizer. Unless upping the Geodon is an option, which I think it's not.
>
> This seems simple to me. I just don't know what to do.
S,
Are you going to do this modification to your taking of drugs on your own? If so, where are you going to get the drug(s)?
Lou
Posted by Sheilac on September 30, 2014, at 8:01:40
In reply to Lou's reply-howyagonnagetum » Sheilac, posted by Lou Pilder on September 30, 2014, at 7:57:28
I have both depakote and Trileptal at home. For the past 8 months I've only been taking Geodon it worked for depression and mood stabilization.
The elavil has thrown me into a hypomanic state.
I'm not sure what med to take, but I have to do something before I go crazy. I don't think Geodon is a good mood stabilizer with elavil.
Posted by Lou Pilder on September 30, 2014, at 8:20:34
In reply to Re: Lou's reply-howyagonnagetum » Lou Pilder, posted by Sheilac on September 30, 2014, at 8:01:40
> I have both depakote and Trileptal at home. For the past 8 months I've only been taking Geodon it worked for depression and mood stabilization.
>
> The elavil has thrown me into a hypomanic state.
>
> I'm not sure what med to take, but I have to do something before I go crazy. I don't think Geodon is a good mood stabilizer with elavil.S,
You wrote,[...I'm not sure what med to take...I have to do something...].
I am unsure as to what you are wanting to mean here If you could post answers to the following, then I could have the opportunity to respond accordingly.
True or False:
A. The only choice that I have, Lou, is to take either Trileptal or Depakote
B. My prescribing doctor says that I can take drugs without consulting him/her that I have shelved from previous prescriptions.
C. I know, Lou, what the tragic consequences could be to me by combining the drugs that I am already taking with either Depakote or Trileptal.
D. I will either add Depakote or Trileptal to the drugs that I am taking now, on the basis of what another poster says to me here.
Lou
Posted by SLS on September 30, 2014, at 10:00:12
In reply to Re: Depakote + Elavil ?! » Christ_empowered, posted by Sheilac on September 30, 2014, at 6:19:40
You might want to discontinue the Elavil for now and develop a coherent plan to follow with your doctor. That would be the simplest thing to do.
You are not necessarily experiencing serotonin syndrome, so I would not act on that conclusion until you gather more information. It could explain things, though.
If you feel that it is urgent to treat mania, go with what you know works for you, understanding that it will only be a temporary measure. In other words, if Trileptal or Depakote works to treat the mania, but produces depression as a side effect, just know that you will be able to discontinue it once you and your doctor meet and discuss your present condition.
You often contradict yourself in your descriptions. Because of this, I am reluctant to say very much more than to recommend that you work more closely with your present doctor or search for a different doctor. You could go for a second opinion. I know it is frustrating to be in a painful state and not be able to do something about it immediately.
- Scott
Posted by Sheilac on September 30, 2014, at 10:33:27
In reply to Lou's reply-tehykehychanz » Sheilac, posted by Lou Pilder on September 30, 2014, at 8:20:34
So noted. I get your point. Luckily my doc called me and said I should not be taking Geodon and Elavil. She switched me over to depakote so the Elavil won't make me manic.
Posted by Sheilac on September 30, 2014, at 10:38:34
In reply to Re: Depakote + Elavil ?! » Sheilac, posted by SLS on September 30, 2014, at 10:00:12
Thanks Scott. Yes it is terrible to feel so hypomanic. But unfortunately the Elavil is working for my pain condition. My doc did call me and said to wean off Geodon immediately and add the depakote, which I will do until I see her next time.
I don't think the depakote will induce depression considering the Elavil is having a profound antidepressant effect on me.
My doctor agreed.
Posted by SLS on September 30, 2014, at 12:06:40
In reply to Re: Depakote + Elavil ?! » SLS, posted by Sheilac on September 30, 2014, at 10:38:34
> Thanks Scott. Yes it is terrible to feel so hypomanic. But unfortunately the Elavil is working for my pain condition. My doc did call me and said to wean off Geodon immediately and add the depakote, which I will do until I see her next time.
>
> I don't think the depakote will induce depression considering the Elavil is having a profound antidepressant effect on me.
>
> My doctor agreed.
Sounds good to me!:-)
- Scott
Posted by Lou Pilder on September 30, 2014, at 21:02:51
In reply to Re: Lou's reply-tehykehychanz » Lou Pilder, posted by Sheilac on September 30, 2014, at 10:33:27
> So noted. I get your point. Luckily my doc called me and said I should not be taking Geodon and Elavil. She switched me over to depakote so the Elavil won't make me manic.
>
> S,
Now you have a whole new host of life-threatening problems by adding the Depakote to replace the Geodon. You see, Depakote can cause a disruption of the heart beat function with the other drugs that you take and be life-threatening. Also, confusion and seizures, and movement disorders and poor judgment can also come from this combination. And Depakote can attack the organs and cause even blood disease. Suicidal and homicidal thinking can emerge with this combination.
Lou
Posted by SLS on September 30, 2014, at 21:32:43
In reply to Lou's reply-leadztudizstrkun » Sheilac, posted by Lou Pilder on September 30, 2014, at 21:02:51
Are these effects dosage-dependent?
- Scott
Posted by Lou Pilder on October 1, 2014, at 8:05:06
In reply to Re: Lou's reply-leadztudizstrkun » Lou Pilder, posted by SLS on September 30, 2014, at 21:32:43
> Are these effects dosage-dependent?
>
>
> - ScottScott and friends,
The use of the drug called Depakote has a wide range of adverse effects just taken by itself. But these effects are much greater when the drug is combined with the drugs that our member here is taking. The adverse effects are magnified exponentially when combined with other psychoactive drugs This means that when taken in combination with other psychotropic drugs, the chance of , let's say, death from liver failure or failure of the pancreas or death from blood disease is {exponentially} increased. So the dosage as taken as directed will be exponentially magnified in the creation of death by organ disease such as the liver or pancreas. As to if there is some low dose that could not induce these tragic consequences, I do not think so, for there is the exponential effect when taken in combination with other drugs that act on the nervous system.
The drug has constituents that have been known for thousands of years to effect the mind. The drug was used by sorcerers in the ancient times. And today, there are a new generation of sorcerers giving the drug with the same consequences that can lead to death.
And here, this drug is allowed to be openly promoted to be taken in combination with other psychoactive drugs that could kill the person taking those drugs. And if the drug itself does not kill the person by liver failure or blood disease or disease of the pancreas, such confusion from the drug could cause the taker of the drug to act irrationally and be killed accidentally. Oh, the horrors of it all
Here is a link noting the effects from the drug.
http://www.rxlist.com/depakote-side-effects-drug-center.htm
Lou
Posted by Sheilac on October 1, 2014, at 8:13:58
In reply to Re: Lou's reply-leadztudizstrkun » Lou Pilder, posted by SLS on September 30, 2014, at 21:32:43
My doc did not feel it was safe for me to be on Geodon and a trycylic.
She checked the combo of low dose Elavil and low dose depakote and said it was fine.
Do you just not like meds at all Lou?
Posted by Lou Pilder on October 1, 2014, at 8:30:44
In reply to Re: Lou's reply- lou + Scott, posted by Sheilac on October 1, 2014, at 8:13:58
> My doc did not feel it was safe for me to be on Geodon and a trycylic.
>
> She checked the combo of low dose Elavil and low dose depakote and said it was fine.
>
> Do you just not like meds at all Lou?S,
You wrote the above. And you say that your doc agreed with me that the combination of Geodon and Elavil was not safe. Then if I am following this correctly, some doctor prescribed the combination to you thinking that it was safe? Was it the same doctor?
Now she says that it is fine to take Depakote with Elavil in a low dose. Where does she get such assurance?
Lou
Posted by SLS on October 1, 2014, at 9:16:02
In reply to Re: Lou's reply- lou + Scott, posted by Sheilac on October 1, 2014, at 8:13:58
> My doc did not feel it was safe for me to be on Geodon and a trycylic.
>
> She checked the combo of low dose Elavil and low dose depakote and said it was fine.
>
> Do you just not like meds at all Lou?I think that Lou Pilder usually has noble motivations.
Mr. Pilder's observation that there is the potential for a combination of Geodon (ziprasidone) and Elavil (amitriptyline) to produce changes in heart rhythm is justified. However, I don't know under what circumstances this is liable to occur. I, myself, had no problems when I combined desipramine 200 mg/day with Geodon 80 mg/day.
Regarding Depakote (valproate) and liver toxicity, this adverse effect is dosage dependent, and easy to screen for. One should have a blood test for liver enzymes before taking Depakote in order to establish baseline measurements. This should be repeated periodically during the first six months, whereafter, the probability of liver toxicity declines rapidly. Full liver failure is considered to be a rare occurrence.
At higher dosages, one should assay blood platelet function to screen for thrombocytopenia (low platelet count).
- Scott
Posted by Sheilac on October 1, 2014, at 11:58:29
In reply to Lou's reply- whtzonpsecun » Sheilac, posted by Lou Pilder on October 1, 2014, at 8:30:44
No. One doc gave me Elavil to take for neuropathy and she said she didn't know what Geodon was! Now adays with all the electronic health records, you'd think it would have raised a red flag.
It was only after a week of getting more and more manicy that I called my pdoc and she was not comfortable with the possible heart issues when combining Elavil with Geodon. She was very frustrated with my other doctor.
My pdoc told me to wean down/off Geodon and take Depakote to calm down the hyperness the antidepressant (Elavil) was causing.
She also mentioned that depakote could increase the blood levels & side effects of Elavil. She mentioned that some people take depakote for neuropathy. It's not usually the first choice, but she said it might also help with that.
So I'm taking only 20mg of Elavil now in the morning because it revs me up (was taking 30). And I'm taking 250mg depakote at night, but this morning I felt jittery still, so I took 125mg of Depakote. I'm not taking in any caffeine or stimulant of any type.
My pdoc is fine with this. She wants me to stay stable until I see her in 2 weeks.
I'm a low dose girl, so 250mg of depakote really does help.
Posted by Lou Pilder on October 1, 2014, at 12:56:49
In reply to Re: Lou's reply- whtzonpsecun » Lou Pilder, posted by Sheilac on October 1, 2014, at 11:58:29
> No. One doc gave me Elavil to take for neuropathy and she said she didn't know what Geodon was! Now adays with all the electronic health records, you'd think it would have raised a red flag.
>
> It was only after a week of getting more and more manicy that I called my pdoc and she was not comfortable with the possible heart issues when combining Elavil with Geodon. She was very frustrated with my other doctor.
>
> My pdoc told me to wean down/off Geodon and take Depakote to calm down the hyperness the antidepressant (Elavil) was causing.
>
> She also mentioned that depakote could increase the blood levels & side effects of Elavil. She mentioned that some people take depakote for neuropathy. It's not usually the first choice, but she said it might also help with that.
>
> So I'm taking only 20mg of Elavil now in the morning because it revs me up (was taking 30). And I'm taking 250mg depakote at night, but this morning I felt jittery still, so I took 125mg of Depakote. I'm not taking in any caffeine or stimulant of any type.
>
> My pdoc is fine with this. She wants me to stay stable until I see her in 2 weeks.
>
> I'm a low dose girl, so 250mg of depakote really does help.S,
You wrote the above
Now I don't claim to be an "A" student. But this much I know. The literature states that Depakote can induce fatal agranulocytosis as well as other blood abnormalities that could cause death. This is compounded by the fact that you are taking other psychotropic drugs along with Depakote.
Now Scott says that before one takes Depakote, an assessment for determining if liver failure could happen is made. Did your doctor order this assessment for you before you took the Depakote?
Now you have a doctor allowing you to take Elavil along with Depakote. I guess you trust him/her. But I say to you, if the one doctor was negligent by not checking other drugs that you were taking, and if there is now another doctor involved, could not this doctor also be negligent that could cost you your life? Does that a doctor prescribes one a drug(s) make it so that one could not die from the drug(s)?
Lou
Posted by Lou Pilder on October 1, 2014, at 13:13:21
In reply to Lou's reply-ehydonoizonthrd » Sheilac, posted by Lou Pilder on October 1, 2014, at 12:56:49
> > No. One doc gave me Elavil to take for neuropathy and she said she didn't know what Geodon was! Now adays with all the electronic health records, you'd think it would have raised a red flag.
> >
> > It was only after a week of getting more and more manicy that I called my pdoc and she was not comfortable with the possible heart issues when combining Elavil with Geodon. She was very frustrated with my other doctor.
> >
> > My pdoc told me to wean down/off Geodon and take Depakote to calm down the hyperness the antidepressant (Elavil) was causing.
> >
> > She also mentioned that depakote could increase the blood levels & side effects of Elavil. She mentioned that some people take depakote for neuropathy. It's not usually the first choice, but she said it might also help with that.
> >
> > So I'm taking only 20mg of Elavil now in the morning because it revs me up (was taking 30). And I'm taking 250mg depakote at night, but this morning I felt jittery still, so I took 125mg of Depakote. I'm not taking in any caffeine or stimulant of any type.
> >
> > My pdoc is fine with this. She wants me to stay stable until I see her in 2 weeks.
> >
> > I'm a low dose girl, so 250mg of depakote really does help.
>
> S,
> You wrote the above
> Now I don't claim to be an "A" student. But this much I know. The literature states that Depakote can induce fatal agranulocytosis as well as other blood abnormalities that could cause death. This is compounded by the fact that you are taking other psychotropic drugs along with Depakote.
> Now Scott says that before one takes Depakote, an assessment for determining if liver failure could happen is made. Did your doctor order this assessment for you before you took the Depakote?
> Now you have a doctor allowing you to take Elavil along with Depakote. I guess you trust him/her. But I say to you, if the one doctor was negligent by not checking other drugs that you were taking, and if there is now another doctor involved, could not this doctor also be negligent that could cost you your life? Does that a doctor prescribes one a drug(s) make it so that one could not die from the drug(s)?
> Lou
>
S,
The issue here could mark the difference between you being a live person or a corpse. Here is a link concerning Depakote and warnings.
Lou
http://www.drugs.com/pro/depakote-capsules.html
Posted by herpills on October 1, 2014, at 13:28:36
In reply to Re: Lou's reply-leadztudizstrkun » Lou Pilder, posted by SLS on September 30, 2014, at 21:32:43
> Are these effects dosage-dependent?
>
>
> - ScottApparently if you take 0.00001mg you will die.
Posted by Sheilac on October 1, 2014, at 13:46:05
In reply to Re: Lou's reply-leadztudizstrkun » SLS, posted by herpills on October 1, 2014, at 13:28:36
Well geez. Maybe I should just take the Trileptal as my mood stabilizer. Would that be safer?
Maybe just Trileptal and Elavil
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Dr. Bob is Robert Hsiung, MD,
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