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*Beth*
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Default Nov 25, 2022 at 04:45 PM
  #1
November 25th, 2022


Current Medications
- Lamictal 200mg at bedtime
- Topomax 50mg a.m./50mg p.m.
- Gabapentin 900mg a.m./900mg p.m.
- Klonopin .75 mg a.m./1mg p.m.
- Metformin 500mg a.m./500mg p.m.
- Amlodipine 10mg p.m.
- Seroquel 25mg (for sleep)

- Various sleep aids: Melatonin, ZzzQuil, Tylenol P.M.


Current Prescribers
SK, PA
Dr. B. (GP)
Dr. D (maybe) for K-pin reduction


Depression and anxiety/panic, also agoraphobia, beginning slightly in later October, worsening, by time change in November severe and getting worse until mid-later November extremely severe. S. raised Topomax on 11/22 to 100mg/day. That dose began to help almost immediately. By today (11/25) I feel less terrified, more motivated. Still not stable, but better than I was. I would like to increase both Topomax and Gaba.



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Red face Nov 25, 2022 at 07:39 PM
  #2
Raising the gaba first makes since. I have heard that you don't want to mess around with multiple med changes as you don't know what does what.
bizi

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150mg of lamictal 2x a day
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Default Nov 25, 2022 at 11:16 PM
  #3
I hope you feel better soon beth.

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Default Nov 26, 2022 at 02:31 PM
  #4
Beth

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Default Nov 26, 2022 at 04:31 PM
  #5
Thank you bizi, Mm, and Fuzzy Dear for your friendship

bizi, I wanted to raise the Gaba. med dude was reluctant. Said 1800mg is ceiling dose for anxiety. No, it is not. Finally he scrolled on his phone and agreed that well, maybe the dose could go higher. Yes, of course, they never want to increase 2 meds at the same time. I do understand why, but when a depression/anxiety is this severe my feeling is, go ahead and raise both meds. I had an excellent & experienced pdoc who would occasionally do that. Raising 1 then waiting 2 weeks to raise the other...it's just too long. I'm considering raising the Gaba myself, then telling med dude I accidentally dropped the open bottle and lost a bunch of the capsules in dishwater. Or something like that.

Anyway, thankfully, the Topomax definitely is helping decrease the depression.

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Heart Nov 26, 2022 at 09:14 PM
  #6
I am very glad that the topamax is helping with your depression!!!!
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multi vit,, vit c, at noon, tumeric, caffeine at noon
PRN Remeron 15mg at night,
zyprexa10mg under tongue,
requip2mg.





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Default Nov 26, 2022 at 10:05 PM
  #7
I'm glad the topamax is helping the depression too. I hope you feel better. It would be wise to at least space out the increases a couple days in case anything does happen with either of them. I've rarely had a pdoc make two changes at once and even then it was IP.

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Default Nov 26, 2022 at 10:19 PM
  #8
Does the melatonin help with sleep?
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Default Nov 27, 2022 at 01:08 AM
  #9
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Originally Posted by Crazy Hitch View Post
Does the melatonin help with sleep?

Yes, it does. So far I seem to still be stuck with taking the 25mg Seroquel (which by itself doesn't make me sleep). But the Seroquel and the melatonin (or switching off melatonin with other otc sleep aids) does help. My goal is to try a melatonin/valerian root combination and cut down on the Seroquel, hoping to stop taking it by late spring. I used to use valerian to help my sleep when it was a loose herb, I'd make a tea from it and that stuff stunk SO bad

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Default Nov 27, 2022 at 01:12 AM
  #10
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Originally Posted by MuddyBoots View Post
I'm glad the topamax is helping the depression too. I hope you feel better. It would be wise to at least space out the increases a couple days in case anything does happen with either of them. I've rarely had a pdoc make two changes at once and even then it was IP.

Thanks, Boots. Yeah, I know, you're smart, I trust you and you're correct about spacing them out. Seriously, unless I am really freaking out with severe anxiety I'll do my best (try, anyway) to wait it out with the Gaba. Or, what I'll try is calling for an earlier appointment.

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Heart Nov 27, 2022 at 03:24 PM
  #11
I can't sleep with out a benzo. I take 1mg of klonipin and have for years.
So are you still taking klonipin with other sleep aides?
just curious.
bizi

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150mg of lamictal 2x a day
haldol 5mg 2x a day
1mg of cogentin 2x a day
klonipin , 1mg at night,
4-5 peri-colace for chronic constipation


multi vit,, vit c, at noon, tumeric, caffeine at noon
PRN Remeron 15mg at night,
zyprexa10mg under tongue,
requip2mg.





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Default Nov 27, 2022 at 07:38 PM
  #12
I'm sorry you can't sleep because of anxiety - I'm feeling similarly this evening.

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Default Nov 28, 2022 at 10:39 AM
  #13
Beth's Keeping Track Post #2

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Default Nov 28, 2022 at 07:42 PM
  #14
Quote:
Originally Posted by bizi View Post
I can't sleep with out a benzo. I take 1mg of klonipin and have for years.
So are you still taking klonipin with other sleep aides?
just curious.
bizi

Hi bizi, I've been on Klonopin for about 30 years, so it's not helping me with sleep or anything else anymore, and hasn't for many, many years (decades). I'm just physically addicted to it at this point. I could (literally) take 8 mgs before I'd get sleepy from Klonopin (I've done it in the past, when I was desperate to sleep).

I'm prescribed the 25mg Seroquel for sleep, but that amount isn't enough to really make me sleep (I just lie there, awake for 60 to 90 minutes). 50mg would knock me out, but I don't want to take that much Seroquel. That's why I take the otc sleep aids.

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Default Nov 28, 2022 at 07:47 PM
  #15
Spent quite a bit of time with M. (therapist) going over the appointment I had with Dr. D. She and I concluded that I won't be returning to see him. I am seriously shaken up from his hostile manner. She's had several clients complain to her about him, similar complaints to mine. Her take is that it's quite possible he doesn't have the knowledge of how to treat a patient who has a mental illness and needs to be on psych meds, so he got defensive. She did encourage me to fill out a comment card, which I will do. She said that the "higher-ups" really do pay attention to patient input.

Something I thought about is that if he's around to help people get off medication, well, then there must be other doctors around here that do the same. I'll continue to decrease the k-pin on my own, very slowly, and in spring check around for a different addiction MD.

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Default Nov 29, 2022 at 12:33 AM
  #16
You had such high hopes for him I'm sorry.

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Default Nov 29, 2022 at 09:28 AM
  #17
I hope you'll be able to find a doc that can take you off Kpin without being an asshole about it. I'm sorry you keep getting these unhelpful docs. I agree with your therapist that you shouldn't go back.

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Default Nov 29, 2022 at 10:04 AM
  #18
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You had such high hopes for him I'm sorry.

I did, and that is so kind of you, Mm. Thank you

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Default Nov 29, 2022 at 10:05 AM
  #19
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I hope you'll be able to find a doc that can take you off Kpin without being an asshole about it. I'm sorry you keep getting these unhelpful docs. I agree with your therapist that you shouldn't go back.

Thank you, Boots. I appreciate your input, and trust it

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Default Nov 30, 2022 at 10:47 PM
  #20
Had an appointment with med due this afternoon. I was sitting in the waiting room, where there was a lovely Christmas tree. I moved so I didn't have to look at it. I don't know why.

Then there was a girl, about 12, sitting across from me. She looked right at me and smiled the sweetest smile. Fortunately, at that moment her therapist called her back because I started crying. I was crying with tears rolling down my face, wiping them away with my sleeves and the more I tried to stop, the more the tears came. I tried to take deep breaths, but couldn't. All I could do was cry. Everything in the entire universe just seemed destined to suffer and I could not stop crying. Then med dude called me back and I felt bad for him because he looked at me and he looked like he felt sorry for me.

I felt sorry for him that he has a job that requires him to feel sorry for people all day. But of course, that's what makes him good at his job. He's empathetic. He's a sweet kid. I told him he reminds me of my son; he's tall and he's kind. He smiled. That made me cry more and by the time I got into his office and sat down I was crying so hard that the only thing that kept from from total panic, thinking my God I'm going to cry until I'm all shriveled up, was knowing that I have cried many times in my life and eventually it does stop. There comes a point.

The whole thing was not fun. But I suppose it did communicate to med dude, who was so, so kind about all of it, exactly what a terrifyingly depressed/anxious state I've been in since early/mid-ish October. Also, he appreciated the information from my therapist inviting him to communicate with her and had me sign a release form for that.

Updated medication plan:
-Topomax 100mg a.m./100mg p.m.
- Gabapentin Add 300mg a.m./Add 600mg p.m.

After 3 days:
-Topomax increase to 200mg a.m./200mg p.m.

Appointment next week.

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