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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by lepus on February 15, 2004, at 17:26:51
I have a pdoc appt coming up and I need some help and would love some from all the wise PBers. First, I am going to give some history on myself and see what you guys think about what med direction I need to go in now.
I was dx'd with panic disorder when I was 11. I had all the classic signs of panic disorder at that time. No abuse is in my history that brought on the panic. I assume it happened due to family history of the disorder and hitting puberty. I was put on Imipramine and everything was basically fine until I hit 16. At that time I smoked a joint that I think was laced with something and had a psychotic break for the rest of the night much like being on LSD. I have not used drugs since. From that night on however I started to have disassociative symptoms and the anxiety came back worse than ever. I went to the psychiatrist where we tried so many things, basically every class of drugs except MAOIs. I am sorry now that I didn't write down every drug we tried and in what combinations. As time went on I got better but was never really the same as before the pot incident. I should say that Klonopin seems to have been the wonder drug to get me out of the anxiety at this time. I still take it today.
When I hit my early twenties I would have times where I was fairly functional with just a low-lying depression and then would have days where I just couldn't get out of bed. I would sleep all day and then be up most of the night. It seemed like my circadian rhythms just shifted. I still had some panic attacks in certain situations, like upper floors of buildings or places I couldn't get out of easily. During this time I was on various SSRIs and the Klonopin. It never really helped much. There does seem to be a seasonal component to it where I feel better in the summer and worse in the fall/winter.When I was 27 I went off to school again with Effexor XR, Ambien, Klonopin and some Xanax. I ended up trying to commit suicide. I think the Effexor did something weird to me. I never thought of suicide before but it seemed to trigger the thoughts and make it a more plausible solution. Since I had recently broken up with someone and quit college when I got to the hospital for the suicide attempt I got the Borderline label as well as MDD and panic disorder I believe. Since then I have been dx'd as BPII but I am not so sure of that dx. I think I might just be depressed over panic attacks that won't remit and a life in chaos and shatters.
Three months after my suicide attempt I went off all meds except the Klonopin and the med I was taking for my thyroid. It was in the fall of last year that I did this. I went on the have the best year of my life functionally. I held my first 9-5 job ever and did well and was promoted. Come fall I started having trouble getting out of bed again and my anxiety jumped through the roof. I would be remiss not to mention that around this time I was also getting out of a relationship, moved to a new apartment, father had a heart attack, got promoted at work and found out my brother was getting divorced. So there was certainly some stress. I went to a psychotherapist and a pdoc. The pdoc put me on Lexapro and Lamictal. The combo of starting both together put me through the roof in terms of anxiety. I quit taking them. My anxiety just kept getting worse and worse. I took leave from work. I never went back. I moved back home because I was not eating and was scared to try meds out again alone after the Effexor experience. I saw a new pdoc here and he started me on Depakote ER and Seroquel and after time started Lexapro again. Here is my med combo now:
Depakote ER 1000mg
Lexapro 10mg
Klonopin 2mg
Seroquel 25mg
Levoxyl 25mcgI have been on this combo for about 2 months (less with the Lexapro). I still don't feel right. I again feel better at night than during the day, have anxiety, at times am too depressed to do much of anything but have other days when I am more functional and basically just don't know where to go from here in terms of meds. It seems I feel worse since the Lexapro. I just feel out of it and am sleeping more. I have never really responded well to SSRIs. I don't know about the BPII dx. Why did I feel better off meds? Panic and anxiety seem to be my real problem and still are. I feel drugged up and hanging by a thread and like I am not getting the right help meds wise.
So what do I tell my pdoc? I want to streamline these meds because I just feel drugged and like I am getting more side effects than benefits. I am still anxious. And what about the BPII dx? I don't think I have ever really been hypomanic. Okay, I am getting tired of writing but I would appreciate some help on where to go with meds from here and what you all think a dx might be or what the heck is going on!! If you need more info just ask...
Thanks...
Posted by leo33 on February 15, 2004, at 23:47:36
In reply to help with pdoc appt (long), posted by lepus on February 15, 2004, at 17:26:51
Lepus, I think you should print out what you just wrote and give that to your doctor!
Posted by lepus on February 16, 2004, at 13:18:51
In reply to Re: help with pdoc appt (long), posted by leo33 on February 15, 2004, at 23:47:36
> Lepus, I think you should print out what you just wrote and give that to your doctor!
Thanks for the idea Leo, but she knows all of it already. :(
Posted by terrics on February 16, 2004, at 20:16:59
In reply to help with pdoc appt (long), posted by lepus on February 15, 2004, at 17:26:51
Hi, just wanted to say I noticed that you said that your main problem is panic attacks. Your on an awful lot of meds for panic attacks. I think you know yourself better than pdoc and if you think the bipolar 2 dx is incorrect it probably is. Re the night and day thing....some of us just have reversed circadian rhythms. DO you think being on klonopin and the thyroid med. might be enough? Do you think you have any other dx besides panic? Would therapy help? terrics
Posted by lepus on February 16, 2004, at 21:53:49
In reply to Re: help with pdoc appt (long) » lepus, posted by terrics on February 16, 2004, at 20:16:59
> Hi, just wanted to say I noticed that you said that your main problem is panic attacks. Your on an awful lot of meds for panic attacks. I think you know yourself better than pdoc and if you think the bipolar 2 dx is incorrect it probably is. Re the night and day thing....some of us just have reversed circadian rhythms. DO you think being on klonopin and the thyroid med. might be enough? Do you think you have any other dx besides panic? Would therapy help? terrics
I think I probably just have an undertreated anxiety disorder and BPD, my pdoc who has known me for 13 years thinks I have something on the bipolar spectrum or major depression and panic. The Klonopin and thyroid were not working alone starting this fall. My anxiety started coming back something fierce. I really am not sure about another dx besides panic. In some ways the BPII makes sense because I am depressed sometimes and then more functional and less depressed at other times but it would be a very mild hypomania at best I believe. I guess now I don't know how to tell my doctor that this dx doesn't feel right and that I need off some of these meds. I just don't know what is wrong with me and therefore don't know how to fight it or what medications are right for me.
Yes, I think therapy will be beneficial and I am starting it now.
Thanks for your input. I just don't know what to do about the meds.
This is the end of the thread.
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