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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by mtdewcmu on April 22, 2011, at 17:26:31
I think I accidentally overdosed on serotonergic drugs by switching too fast from Paxil to Luvox and adding Dexedrine. For a few days I was hallucinating, stumbling like a drunk, and my pupils were dilated, plus lots of anxiety and insomnia. In other words, probably serotonin syndrome. At the time, I did not know what the heck was going on.
Today I took only 20mg of Celexa, and my longer-term plan is to stick with a conservative dose of Celexa as my only AD. So far, today, I feel pretty ok. Celexa was a good drug for me for a few years, before pooping out. Hopefully, I can get more mileage out of it.
Posted by Phillipa on April 22, 2011, at 18:05:39
In reply to Difficult Lesson Learned, posted by mtdewcmu on April 22, 2011, at 17:26:31
Both have a relatively short half-life not like prozac or some others. Wasn't the dose of luvox low? My pdoc always just did a switch didn't wait inbetween like with maois. I now take two SSRI's in low doses and so far have had no problems been almost a year now. Did you call your doc and ask? I wonder if luvox isn't the med for you? A paradoxical side effect? Were you on the dexadrine before. Sorry I forget. Any other factors that could have caused this reaction in you? I'm so sorry you have suffered a lot. Phillipa
Posted by mtdewcmu on April 22, 2011, at 18:20:05
In reply to Re: Difficult Lesson Learned » mtdewcmu, posted by Phillipa on April 22, 2011, at 18:05:39
> Both have a relatively short half-life not like prozac or some others. Wasn't the dose of luvox low? My pdoc always just did a switch didn't wait inbetween like with maois. I now take two SSRI's in low doses and so far have had no problems been almost a year now. Did you call your doc and ask? I wonder if luvox isn't the med for you? A paradoxical side effect? Were you on the dexadrine before. Sorry I forget. Any other factors that could have caused this reaction in you? I'm so sorry you have suffered a lot. Phillipa
The problem with Paxil is that it is a very potent inhibitor of CYP2D6. Luvox is also a potent inhibitor of a few other CYP enzymes. So I think they prevented each other from being metabolized, leading them to accumulate. The Dexedrine may have made it worse. I'm not sure whether Remeron was a net positive or negative.
Posted by sigismund on April 22, 2011, at 20:18:04
In reply to Re: Difficult Lesson Learned, posted by mtdewcmu on April 22, 2011, at 18:20:05
>my pupils were dilated,
Artane does that too.
Posted by mtdewcmu on April 22, 2011, at 21:25:27
In reply to Re: Difficult Lesson Learned, posted by sigismund on April 22, 2011, at 20:18:04
> >my pupils were dilated,
>
> Artane does that too.I'm aware of that, but I don't think it was the Artane.
Posted by Phillipa on April 23, 2011, at 19:55:26
In reply to Difficult Lesson Learned, posted by mtdewcmu on April 22, 2011, at 17:26:31
How you feeling today? Any better hoping so. Phillipa
Posted by mtdewcmu on April 23, 2011, at 21:37:03
In reply to Re: Difficult Lesson Learned » mtdewcmu, posted by Phillipa on April 23, 2011, at 19:55:26
Thanks for asking, Phillipa. I went back to Celexa (not sure if I posted this already or not), and I think Celexa is starting to help me already. I was on Celexa at 40mg, and then at 60mg for several years, and finally decided to try something else as Celexa had seemed to poop out. I can't remember anymore how long it has been since I quit Celexa, it's been more than a year, maybe two. Well, it's probably too early to tell, but I think Celexa may again hold my salvation. I had been in a state of agitated depression for the past couple months, wishing for the nerve to end it all, but today there seemed to be a light at the end of the tunnel. I took 20mg in the morning, and then I started feeling sad around 6pm so took another 10mg. I also took Wellbutrin 300mg today, and I think I will probably take Remeron tonight.
Posted by Phillipa on April 23, 2011, at 21:44:28
In reply to Re: Difficult Lesson Learned » Phillipa, posted by mtdewcmu on April 23, 2011, at 21:37:03
I'm sorry you felt sad. Did the morning dose work till 6pm? Do you feel better now since took the wellbutrin? Hoping so. Phillipa
Posted by mtdewcmu on April 23, 2011, at 22:23:32
In reply to Re: Difficult Lesson Learned » mtdewcmu, posted by Phillipa on April 23, 2011, at 21:44:28
> I'm sorry you felt sad. Did the morning dose work till 6pm? Do you feel better now since took the wellbutrin? Hoping so. Phillipa
I felt more hopeful before around 6, when the sun started going down. I think the WB helped somewhat today. It's hard to judge a trend based on one day. I'm hopeful that tomorrow will be bearable, and then on Monday I can get more Dexedrine, which will hopefully enable me to focus on doing work, rather than feeling hopeless about my situation. I'll try to post updates.
Posted by floatingbridge on April 25, 2011, at 10:56:13
In reply to Re: Difficult Lesson Learned, posted by mtdewcmu on April 23, 2011, at 22:23:32
Mtdew, I'm sorry to read about this. I imagine you're trying to find the right combo. Remember that lots of switches in a short time can cause a short circuit. Do be careful. I hope the celexa holds you a bit steadier. You were ill?
Posted by mtdewcmu on April 25, 2011, at 15:21:12
In reply to Re: Difficult Lesson Learned » mtdewcmu, posted by floatingbridge on April 25, 2011, at 10:56:13
> Mtdew, I'm sorry to read about this. I imagine you're trying to find the right combo. Remember that lots of switches in a short time can cause a short circuit. Do be careful. I hope the celexa holds you a bit steadier. You were ill?
I think I slipped into agitated depression for a while, somewhere around March to mid-April. That is a dangerous state, because you will do almost anything to stop it. I got my pdoc to let me try switching from Paxil to Luvox and try Dexedrine at the same time. In that deranged mental state, patience and moderation counted for nothing, so I switched too rapidly from Paxil to Luvox, which triggered an overdose, and I took way too many Dexedrine. I think the serotonin overdose counteracted the Dexedrine, leading me to take more and more. I wound up basically psychotic for a few days, although not psychotic enough to run around naked and get picked up by the police, fortunately (I've seen that happen to people when I worked at the hospital). Over the past week things have been rapidly improving. I switched back to Celexa, which had been the best SSRI for me by far, and, miraculously, it seems to have regained its effect. Today I picked up a refill on the Dexedrine. I took one tablet (10mg) and it is having a robust effect, unlike last time, when the SSRI-overdose seemed to counteract it. So, to summarize, I think I am on the way to getting my sh*t together.
Thanks for all your concern. I hope things are turning a corner for you as well.
Posted by floatingbridge on April 25, 2011, at 16:06:57
In reply to Re: Difficult Lesson Learned » floatingbridge, posted by mtdewcmu on April 25, 2011, at 15:21:12
So glad to hear from you. It can happen, can't it? Talking doctors into things, that is.
Whew.
Thanks for your kind words--I wish for your corner to be right there for you to turn as well.
Chin up, as *they* say.
: P
Posted by mtdewcmu on April 25, 2011, at 17:00:37
In reply to Re: Difficult Lesson Learned » mtdewcmu, posted by floatingbridge on April 25, 2011, at 16:06:57
> So glad to hear from you. It can happen, can't it? Talking doctors into things, that is.
>My current pdoc is much easier to talk into things than the last one. In fact, the last guy seemed to want to refute and argue against every little thing I said. Regardless of who was right, it didn't make for a good therapeutic relationship. In the end, *I* was right, because I stopped seeing him and so I won by default.
Posted by Phillipa on April 25, 2011, at 20:12:35
In reply to Re: Difficult Lesson Learned, posted by mtdewcmu on April 25, 2011, at 17:00:37
That does explain what happened very well. Congrats on the celexa working again for you!!!! Phillipa
This is the end of the thread.
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