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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by SheilaC on July 31, 2010, at 14:44:42
I seriously think the 40mg of Geodon and nightime Seroquel are making me tooooo tired during the day. Sometimes I just wake up in a really bad mood and am irritable and I really think it's the hangover from the Seroquel and then I pop my AM dose of Geodon and that just makes me more of a zombie.
I just feel awful. Not sure what to do.
Seroquel has always made me feel hungover and awful the next day.
I think I will have to switch my meds up. Maybe I should go back to Lithium during the day? Don't know.
I wonder if I feel this tired and irritable because of taking 2 anti-psychotics?
Posted by ed_uk2010 on July 31, 2010, at 16:07:03
In reply to Dragging + Irritable..., posted by SheilaC on July 31, 2010, at 14:44:42
What is your diagnosis Sheila? With medication on board, what are your most prominent psychiatric symptoms?
Your med combination seems unusual to me. I don't want to comment until I know your diagnosis, however.
Posted by Roslynn on July 31, 2010, at 16:11:15
In reply to Dragging + Irritable..., posted by SheilaC on July 31, 2010, at 14:44:42
Hi,
I just wanted to respond and say that Seroquel seems to stay in your system a long time. I take mine at night too but the "slowness" feeling seems to last all day.
I'm sorry, I hope you find something that works better.
> I seriously think the 40mg of Geodon and nightime Seroquel are making me tooooo tired during the day. Sometimes I just wake up in a really bad mood and am irritable and I really think it's the hangover from the Seroquel and then I pop my AM dose of Geodon and that just makes me more of a zombie.
>
> I just feel awful. Not sure what to do.
>
> Seroquel has always made me feel hungover and awful the next day.
>
> I think I will have to switch my meds up. Maybe I should go back to Lithium during the day? Don't know.
>
> I wonder if I feel this tired and irritable because of taking 2 anti-psychotics?
>
>
Posted by Christ_empowered on July 31, 2010, at 22:22:23
In reply to Dragging + Irritable..., posted by SheilaC on July 31, 2010, at 14:44:42
I still think its the seroquel. Try another sleep aid..maybe hydroxyzine?
Posted by herpills on August 1, 2010, at 10:32:21
In reply to Dragging + Irritable..., posted by SheilaC on July 31, 2010, at 14:44:42
Geodon comes in a 20mg capsule. Maybe you could try splitting the dose to see if that helps? I used to take 40mg in the morning, I would drink 3 cups of coffee and still fall asleep 3-4 hours after I took it. Now I take 20mg in the morning and 40mg at night. herpills
Posted by bleauberry on August 1, 2010, at 12:29:09
In reply to Dragging + Irritable..., posted by SheilaC on July 31, 2010, at 14:44:42
I would never take meds that make me feel awful the next day and am completely baffled when others do. I don't get it. I mean, sure, maybe the med seemed like a good choice at the time, and maybe we had high hopes for it. But it doesn't take long to see whether the choice was on target or not. We don't know till we try. But once we try, then we know. I can't speak for you or anyone else. All I can say is that if it were me taking those meds and they made me feel the way you described, I would be weaning off of them as fast as I could. I feel bad enough without taking some crap that just adds another layer of bad to it all. If a med aint providing significiant benefits that outweight the downsides by a longshot, forget it, that med is not welcome in my body. My body is already telling me it doesn't want it and that it is the wrong molecule to consume. I just have to listen to what my body is telling me.
Posted by ed_uk2010 on August 1, 2010, at 14:09:11
In reply to Dragging + Irritable..., posted by SheilaC on July 31, 2010, at 14:44:42
To be perfectly honest Sheila, I think your med combo is rather illogical. I am having great difficultly understanding why your doctor is insisting that you take this combination. I get the impression that your psychiatrist is not listening to what you tell him. If the Seroquel is making you feel unwell, why is he continuing to prescribe it?
Taking two different anti-psychotics together is controversial at the best of times, even in schizophrenia. Unless you are suffering from prominent delusions and/or hallucinations, I would seriously question whether the combination of two anti-psychotics is appropriate.
Secondly, I believe that you are taking amphetamine (Adderall). Combining stimulants with anti-psychotics is not often appropriate. I do not understand the reason for this combination.
Simpler medication regimens are sometimes best. Although I do not want to tell you to go against your doctors advice, I do question his logic. If you stopped the Seroquel, you might not need the Adderall to wake you up. If you stopped the Adderall, you might not need clonazepam to calm you down at night. Taking Geodon on its own (at a low dose) might actually be sufficient.
Finally, why is your doctor so preoccupied with whether or not you have a cup of coffee in the morning? It seems very strange to tell you that you must avoid coffee.....and then to prescribe you amphetamine.
Posted by SheilaC on August 1, 2010, at 16:27:39
In reply to Re: Dragging + Irritable..., posted by ed_uk2010 on August 1, 2010, at 14:09:11
I agree. I don't understand why he has me taking 2 anti-psychotics anyway. I am diagnosed as BPII. I think he is trying to get me on a regular sleep pattern (with the klonopin and Seroquel). And he is trying to treat the daytime irritability with Geodon.
Problem is he doesn't believe me when I tell him that Geodon is making me tired. He says it should be making me have energy. But it doesn't.
Right now I just feel tired. And the irritability that the Geodon was treating is back. Now I am irritable because I am so freakin' tired all the time.
I see him tomorrow and I am going to tell him that something has to change. I can't keep taking the Seroquel.
I need sleep, but not the awful, irritable hangover that Seroquel is giving me. Plus - the Geodon is making me a zombie.
I need something for the depression I have been having as well.
Posted by ed_uk2010 on August 1, 2010, at 17:04:43
In reply to Ed: Re: Dragging + Irritable..., posted by SheilaC on August 1, 2010, at 16:27:39
>I agree. I don't understand why he has me taking 2 anti-psychotics anyway. I am diagnosed as BPII. I think he is trying to get me on a regular sleep pattern (with the klonopin and Seroquel).
Taking Klonopin and Seroquel together seems like overkill to me. I think you would be better off without the Seroquel. In general, the use of Klonopin as a sleep aid should be limited to a couple of weeks at most. Tolerance and dependence can set in rapidly.
Here is some advice about how to establish good sleep hygiene:
http://www.sleepeducation.com/Hygiene.aspx
>And he is trying to treat the daytime irritability with Geodon.
I believe you said that Geodon has been effective for this - which is good :)
>Problem is he doesn't believe me when I tell him that Geodon is making me tired.
I find this disturbing. Why is your doctor not listening to you? Drowsiness/fatigue is a common side effect of Geodon. It has been reported in all clinical trials and is clearly listed as a common adverse effect on the manufacturer's information sheet.
>He says it should be making me have energy.Not really. Geodon is an anti-psychotic. It has been shown to reduce manic and psychotic symptoms. It is not supposed to make you feel energetic.
>Right now I just feel tired. And the irritability that the Geodon was treating is back.
In the absence of Seroquel (which appears to be making you feel much worse), the Geodon might still be beneficial. Is there any chance that you can see another doctor? Your current psychiatrist does not appear to be competent.
It is quite worrying that hear that your complaints about your medication are being repeatedly ignored.
Posted by Christ_empowered on August 2, 2010, at 15:08:38
In reply to Re: Ed: Re: Dragging + Irritable..., posted by ed_uk2010 on August 1, 2010, at 17:04:43
and sorry I dismissed your depression in an earlier post.
I agree with ed_uk that your doc doesn't seem like the best one. I mean, your dose of Adderall is, if I recall correctly, pretty low, but still...no coffee, but mixing uppers and downers by Rx is cool? Ummm...OK. Docs do sometimes use stimulants with antipsychotics, but I seem to read about it only in limited circumstances. Back in the day, they did it in controlled combos like ThoraDex and StelaDex and Eskatrol...a *low* dose antipsychotic (acted like a tranquilizer) and a fixed dose of dexedrine were combined to create what as basically an antidepressant w/ some anti-anxiety action. Your combo seems more like your doc's game plan is "I'm gonna knock her out at night, and rev her up in the day!" Not cool.
Have you tried Lamictal? I'm not saying "don't take Geodon," or "don't take an atypical," but an antipsychotic, no matter how "atypical," is pretty heavy artillery for BP II. I mean, I take a neuroleptic, but I've experienced severe mania and psychosis...the risks:benefits ratio is favorable in my case.
Ed's also right about using the Klonopin as a sleep aid. Klonopin loses its ability to promote sleep pretty quickly. It also has a super-long half-life, which may be contributing to your daytime slowness. It could, I imagine, help with nighttime agitation, but it takes forever for Klonopin to kick in...you'd be better off with PRN Ativan or something for that purpose.
I'm not an MD, just a patient, but I do think you need to see someone else. Drink your coffee. Get a new doctor. It'll be OK.
In terms of the depression...I hate to say it, but I personally (just my opinion here) think you should get a new doc, straighten out your meds, and THEN see about treating the depression. At this point, if you add something in, you could get worse; an antidepressant would boost antipsychotic blood levels and might even make you more apathetic and possibly set off some EPS or something. Plus, with Bipolar of all sorts, the ideal way to deal with depression is to get on a good mood stabilizer and then get the dose right (whether that means moving it up OR down) to minimize the depression. Then, if you're still feeling down to the point that you need meds, you can look into doing something about it (antidepressant, stimulant, supplements, whatever).
I hope you can find a better doctor who isn't so controlling and actually listens to you (and who doesn't put you on a weird combo, ignore your complaints, and demand that you give up coffee.)
Good luck!
Posted by ed_uk2010 on August 2, 2010, at 15:32:41
In reply to Dragging + Irritable..., posted by SheilaC on July 31, 2010, at 14:44:42
>Maybe I should go back to Lithium during the day?
Sheila, how do you respond to lithium and why did you stop taking it?
Posted by SheilaC on August 3, 2010, at 8:20:07
In reply to Re: Dragging + Irritable..., posted by ed_uk2010 on August 2, 2010, at 15:32:41
I respond to Lithium pretty well. If I took too much I felt flat and a little depressed. But at lower doses (150 - 300) I felt pretty good. I did start to gain weight or retain water, don't know which one. I just knew my weight went up.
Posted by ed_uk2010 on August 3, 2010, at 15:12:06
In reply to Re: Dragging + Irritable..., posted by SheilaC on August 3, 2010, at 8:20:07
> I respond to Lithium pretty well. If I took too much I felt flat and a little depressed. But at lower doses (150 - 300) I felt pretty good. I did start to gain weight or retain water, don't know which one. I just knew my weight went up.
In that case, it might be worth giving lithium a second trial. At low doses, and with careful monitoring, there is really no need to be afraid of lithium.
This is the end of the thread.
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