![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 26 to 50 of 56. Go back in thread:
Posted by Quintal on April 1, 2007, at 13:45:29
In reply to Re: Betrayed and in what condition?- Phillipa » Honore, posted by Phillipa on April 1, 2007, at 13:14:29
Maybe you came down a little too fast from the Ativan Phillipa? Have you tried taking the equivalent of the Ativan dose in Valium to see if that helps stop the withdrawal symptoms? I know how awful it is, but things do get better once you adjust even though you might not be able to believe that right now.
Q
Posted by Klavot on April 1, 2007, at 14:19:56
In reply to Re: Betrayed and in what condition?- Phillipa, posted by Phillipa on April 1, 2007, at 13:44:00
I don't think making a bona fide wrong diagnosis is the same as male fide lying.
Klavot
> The bottom line is the new pdoc lied to me. He said your anxiety is caused by a physical condition. The internist said not true nothing is wrong with the bloodwork. So I can't go to someone I don't trust and outwarded lied. The false hope of thinking for once that it wasn't psycholocial condition was taken from me when the internist said no it psychological. I'm sorry I'm a wimp. Love Phillipa
Posted by gardenergirl on April 1, 2007, at 14:54:57
In reply to Re: Betrayed and in what condition?- Phillipa, posted by Klavot on April 1, 2007, at 14:19:56
> I don't think making a bona fide wrong diagnosis is the same as male fide lying.
I agree. Different diagnoses or opinions from different providers are often the norm. They're not lying. They are forming an opinion based on their understanding of the information presented to them at that time, filtered by their own experience and ways of looking at things.
Phillipa, he'd have no reason to lie to you. It also sounds to me like It's possible you didn't give the internist enough time to fully participate in your care. If he didn't know about the conference, that's not his fault, and it's not the pdoc's fault. "After" can mean immediately after as in right that minute, later that same week, sometime in the next month, sometime before you're scheduled in again, etc.
I know you're not feeling well, and navigating the way through this whole process is challenging even when we're at our peak. I would just encourage you to try to slow down, take a breath, and give someone a chance. I know it's hard, especially with anxiety. But if one doesn't collaborate with a doc to set up and *follow* a treatment plan, it's impossible to know what works and what doesn't. But I know it's so hard to be patient when you're feeling awful.
I know you've looked for a T before and haven't found one that would be a good arrangement for you. Perhaps you could work with one specifically on your thoughts and feelings about medications. I think this could help you two ways. First, it could help you through the difficult meds trials and adjustment phases. And it would also give you a trial with a T to see if you could work with him or her on other stuff once you get the meds set up in a way that's best for you. If you decided to try this, I think a T who does CBT would be a good choice.
What do you think?
Namaste
gg
Posted by Racer on April 1, 2007, at 15:37:49
In reply to Re: Betrayed and in what condition?- Phillipa, posted by Phillipa on April 1, 2007, at 13:44:00
> The bottom line is the new pdoc lied to me. He said your anxiety is caused by a physical condition. The internist said not true nothing is wrong with the bloodwork. So I can't go to someone I don't trust and outwarded lied. The false hope of thinking for once that it wasn't psycholocial condition was taken from me when the internist said no it psychological. I'm sorry I'm a wimp. Love Phillipa
You'd seen the new pdoc a few times, liked the guy, were starting to trust the guy -- and then ONE visit with an internist who said a few things that I'm distinctly NOT impressed by, and you're giving the internist more credence than the pdoc?
Jan, that internist really doesn't impress me. A lot of doctors will say, "Oh, whatever it is, it's not physical. Must be psychological." How about a show of hands here: how many of us here have heard that from doctors? And how many times has it been untrue? How many times is it physical, but the doctor didn't want to break a sweat? The internist doesn't have all the information, it sounds like. He's only getting part of the story, the raw numbers of the bloodwork which was done exactly when? What drugs were in your system or getting out of your system then? Gee, lemme think -- could changing drugs make a difference in those numbers? WHY didn't he redo the bloodwork?
Honore is right -- you need to do something, because this holding pattern certainly isn't doing you any good. If you don't do anything different, you will stay here, just exactly as unhappy as you are now, but without the hope you've had with this new pdoc.
Instead of running back to what hasn't worked for you, Jan, how about addressing this head on? ASK the pdoc what happened. Don't assume you are able to read not only his mind, but his mind AND the internist's mind.
How many internists know all the nuances of psychiatric treatment? There's a reason we don't go to our GPs for psychiatric treatment, right? This internist only looked at bloods and decided it was psychological? I'm just not impressed.
Jan, you have to decide for yourself if you're going to do what you need to do to get better. You're the only one who can decide to do those things, and you're the only one who'll suffer if you don't.
Good luck.
Posted by Phillipa on April 1, 2007, at 17:28:11
In reply to Re: Betrayed and in what condition?- Phillipa » Klavot, posted by gardenergirl on April 1, 2007, at 14:54:57
GG Got a PHD who works with CBT and just started seeing her too. Wasn't feeling all bad when I saw her. She's the one who gave us the name of this pdoc and said he was good with meds. I just don't know. 40mg of valium? Love Jan ps but I will take your suggestions on working on the med issue.
Posted by Phillipa on April 1, 2007, at 17:33:24
In reply to Um... » Phillipa, posted by Racer on April 1, 2007, at 15:37:49
Racer when the bloodwork was done no changes in meds were being done. Now I'm scheduled with the endo sometime this week for more bloodwork. For the thyroid. Boy I can't imagine what it will say this time. And I will raise my hand for thinking an internist isn't a pdoc. And also he doesn't want to see me again. It's like we made this whole thing up. Oh and gg the conference was supposed to be for that same day the pdoc said. Greg said the internist said he would review the endos chart first. I'm so confused. Love Jan
Posted by Phillipa on April 1, 2007, at 17:53:09
In reply to Re: Um... » Racer, posted by Phillipa on April 1, 2007, at 17:33:24
Guys my head is swimming. I can't process all this info constuctively. And Greg and I just talked as I was starting to cry again and he said he would call this new pdoc tomorrow himself and tell what happened as he was shocked too at the internists and he want's answers too. And he also said that I need to discuss this with the PHD tomorrow. And right now I can't think intelligently so I have no idea what the equivalent of valium to the 6mg of ativan I ended up taking is. Also he said I was doing the best when I had hope and on the xanax. I'm spinning. Please forgive anything I say just not processing . Love Phillipa ps and of course I will get on the phone with the pdoc if he gets him.
Posted by Quintal on April 1, 2007, at 18:34:11
In reply to Re:Head Is Swimming, posted by Phillipa on April 1, 2007, at 17:53:09
That's alright Phillipa. The equivalent in Valium would be ~60mg a day. You see how much difference there is between what you had been taking and how much you're taking now? So it's no wonder you were feeling so dizzy and spaced out when you went on the Ativan, and it's no wonder you're feeling so bad now you're coming off it so fast. The problem is that the Luvox inhibits the breakdown of Valium and complicates things even further. I'd come off that small dose if I were you and see if you can find another antidepressant. I've already given my vote for Lyrica because it boosts GABA and works for both anxiety and depression as well as being a mild mood stabilizer. Hope things improve soon.
Q
Posted by Phillipa on April 1, 2007, at 19:28:09
In reply to (((Phillipa))) » Phillipa, posted by Quintal on April 1, 2007, at 18:34:11
Quintal seriously? I can't believe it. Seriously. So that is why the new pdoc prescribed 40mg of valium? But I only took 6mg of ativan. The 3mg of long acting xanax wasn't bad. So now the question is who do I see and which protocol? And he had said it might come down to antipsychotics and serzone. I know the old pdoc would prescribe lyrica but don't know about this one here. But the drive to the old one 8 hours total. See it's wierd but as the day goes by before all these med changes I used to feel better later in the day. So no valium during the day or any other benzos. So why would I feel better? And the luvox was always taken at night? Are you sure about the values? I know you are.I wish you were here. Love Jan
Posted by greywolf on April 1, 2007, at 19:51:10
In reply to Re: (((Phillipa))) » Quintal, posted by Phillipa on April 1, 2007, at 19:28:09
Phillipa:Racer has always given good advice in the past. Whether or not all the facts are super clear to all of us, I really hope that you take good care of yourself until things get straightened out. Take your valium or whatever else it is you decide on, and maybe see if you can suspend your judgment until everybody talks to everybody else, if you know what I mean.
Take heart that so many people are concerned about you.
Greywolf
Posted by Quintal on April 1, 2007, at 20:19:47
In reply to Re: (((Phillipa))) » Quintal, posted by Phillipa on April 1, 2007, at 19:28:09
>So that is why the new pdoc prescribed 40mg of Valium?
Yes, but even with that you'd obviously still be missing 20mg worth of Valium. With the 25-30mg you're taking now you'll be in a nasty withdrawal. Add that to the fact that you were taking high dose Xanax XR the week before (I thought you were taking 6mg - 3mg in the morning and 3mg at night?). In theory: 3mg Xanax XR = ~60mg Valium, 6mg Xanax XR = ~120mg Valium (though some people dispute these figures because Valium has more hypnotic action, that's still a helluva lot of benzo whatever way you look at it).
I see no reason why he should have a problem with prescribing Lyrica given his (very) liberal prescribing of benzos. I don't understand why you'd feel better later in the day, but that's the way some people experience their depression i.e. it being worst in the morning and getting better in the evening.
Q
Posted by Fivefires on April 1, 2007, at 20:40:14
In reply to Re: (((Phillipa))) » Quintal, posted by Phillipa on April 1, 2007, at 19:28:09
Out here there is a certain religious group that only uses Ativan ... no other benzos allowed.
It's because they feel less addicting. Well it's still addicting we know.
It is tho' one of the less aggressive and less powerful benzos. It's a lightweight. It's fast acting I believe, but then gone pretty fast. Not much like Valium at all.
It's a big step backwards from Valium.
And yeah, if there's a rumor going around that I'm on Librium, it's true.
hugPhillipa, 5f
Posted by Phillipa on April 1, 2007, at 21:18:54
In reply to Re: (((Phillipa))), posted by greywolf on April 1, 2007, at 19:51:10
Greywolf thanks that's the plan now as my husband has read the thread too. I've already taken another 5mg of valium as the pdoc here had said 40mg which I couldn't believe til Q's post. And he's calling the pdoc himself as he wants answers too and truly I'm too out of it to comprhend what he says. Love Phillipa and thanks for caring it is a mess isn't it?
Posted by Phillipa on April 1, 2007, at 22:15:11
In reply to Um... » Phillipa, posted by Racer on April 1, 2007, at 15:37:49
Racer in the shower I remembered my last blood draw for the thyroid was six weeks ago and have another this week and about 9 years ago I all of a sudden had incredible anxiety so bad was hospitalized and when they did the bloodwork my TSH had skyrockedted to 22 so it was my thyroid. I mean what else would cause my high benzo use in a couple of weeks and that would let the pdoc see that I not abusing the benzos. And since it has that wierd auto antigen giving me both graves and hasimotos I have a feeling it's going to have to be destroyed. So you're right. Love Phillipa
Posted by Fivefires on April 2, 2007, at 12:10:20
In reply to Re: Um... » Racer, posted by Phillipa on April 1, 2007, at 22:15:11
Good Morning Phillipa peeps.
I just wanted to let Phillipa know that I tried using my Lyrica 75mg at bedtime last night and awakened 'feeling very good' and 'feeling like I wanted to get up and do something' ... good feelings. Somehow I'd just stopped taking it after the holidays. Will refill.
Anyway, thought I would share.
Phillipa, when we reach out to others for help, see what happens ... we help others too.
I hope you're feeling more 'optimistic' this morning P!
l, 5f
p.s. Do I misunderstand the power of Ativan any1? I've always thought it was near the bottom if u had 'a list of benzodiazepines by strength'.
Posted by Larry Hoover on April 2, 2007, at 12:18:29
In reply to Re: Betrayed and put into what type of condition? » Larry Hoover, posted by Phillipa on April 1, 2007, at 13:07:57
Okay, so your blood work was last done six weeks ago, you're going to get more done, and you're confused about having markers for both Hashimoto's thyroiditis, and Grave's disease.
Here's an excellent little summary review of autoimmune thyroiditis: http://www.api-pt.com/pdfs/2007Aimmuno.pdf
What you'll see there is that both diagnoses are one and the same thing. The only difference is functional, i.e. if your thyroid hormone is high and your TSH low, they call it Grave's, whereas the alternative is called Hashimoto's. The confusing aspect of this is the two names. Hashimoto's is a remitting-recurring disorder, often punctuated by episodes of hyperthyroid (i.e. Hashimoto's can look like one kind of Grave's disease.). Also, anxiety and depression are commonplace with autoimmune thyroiditis. There can even be some rather severe neurological difficulties arising from it. The idea is to get your antibody levels down. There have been some very noteworthy trials of selenium supplementation, which reduce antibody levels dramatically. It really can't hurt you to give that a try. Your dose should be 200 mcg/day of selenium. You can get it anywhere..... Walmart, for example.
Here's another good article. On the 2nd page, there is an excellent description of the symptoms from acute thyroiditis. I wonder if that's exactly what you're feeling....
http://thyroid.about.com/cs/hypothyroidism/a/hashivshypo.htm
There is no fast way to change thyroid function, as the blood serum contains proteins which absorb thyroid hormone like sponges. You've got to stick with the changes you make, to let them become noticeable. I'm sorry this is so hard for you, but your new pdoc is probably right about your psych problems arising with the thyroiditis. Even knowing that, though, doesn't mean we can predict how best to treat your symptoms. You still have to experiment.
Best,
LarBiofactors. 2003;19(3-4):165-70.
Selenium in the treatment of autoimmune thyroiditis.
Gartner R, Gasnier BC.
Department of Endocrinology, Medizinische Klinik Innenstadt, University of Munich, D-80336 Munich, Germany. rgartner@medinn.med.uni-muenchen.deWe recently conducted a prospective, placebo-controlled clinical study, where we could demonstrate, that a substitution of 200 microg sodium selenite for three months in patients with autoimmune thyroiditis reduced thyroid peroxidase antibody (TPO-Ab) concentrations significantly. Forty-seven patients from the initially 70 patients agreed to participate in a follow-up cross-over study for further six months. One group (n = 13), which initially received selenium continued to take 200 microg sodium selenite (Se-Se), one group stopped taking selenium (Se-0) ( n = 9), another group which received placebo started to take 200 microg selenium (n = 14) (Plac-Se) and the last group was without selenium substitution (Plac-0) (n = 11). TPO-Ab concentrations were measured at beginning and the end of the study. In the Se-Se group, the TPO-Ab concentrations further significantly p = 0.004) decreased from 625 +/- 470 U/ml to 354 +/- 321 U/ml, in the Se-0 group the TPO-Ab concentrations increased significantly p = 0.017) from 450 +/- 335 to 708 +/- 313 U/ml. In the placebo group, the TPO-Ab concentrations in those patients who were followed without selenium substitution were unchanged (1351 +/- 940 vs. 1724 +/- 1112 U/ml, p = 0.555). In contrast, the patients who received 200 microg sodium selenite after placebo, the TPO-Ab concentrations decreased significantly (p = 0.029) from 1182 +/- 723 to 643 +/- 477 U/ml.
J Endocrinol. 2006 Jul;190(1):151-6.
Selenium treatment in autoimmune thyroiditis: 9-month follow-up with variable doses.
Turker O, Kumanlioglu K, Karapolat I, Dogan I.
Thyroidology Unit, Department of Nuclear Medicine, GATA Haydarpasa, Istanbul, Turkey. otturker@yahoo.comThe aim of this study is to investigate the long-term (9 months) effects of variable doses (200/100 microg/day) of L-selenomethionine on autoimmune thyroiditis (AIT) and the parameters affecting the success rate of this therapy. The present study was designed in three steps: (1) 88 female patients with AIT (mean age = 40.1 +/- 13.3 years) were randomized into two groups according to their initial serum TSH, thyroid peroxidase antibody (TPOAb) concentrations, and age. All the patients were receiving L-thyroxine to keep serum TSH <or=2 mIU/l. Group S2 (n = 48, mean TPOAb = 803.9 +/- 483.8 IU/ml) received 200 microg L-selenomethionine per day, orally for 3 months, and group C (n = 40, mean TPOAb = 770.3 +/- 406.2 IU/ml) received placebo. (2) 40 volunteers of group S2 were randomized into two age- and TPOAb-matched groups. Group S22 (n = 20) went on taking L-selenomethionine 200 microg/day, while others (group S21) lowered the dose to 100 microg/day. (3) 12 patients of group S22 (group S222) went on taking L-selenomethionine 200 microg/day, while 12 patients of group S21 (S212) increased the dose to 200 microg/day. Serum titers of TPOAb decreased significantly in group S2 (26.2%, P < 0.001), group S22 (23.7%, P < 0.01) and group S212 (30.3%, P < 0.01). There were no significant changes in group C and group S222 (P > 0.05). TPOAb titers increased significantly in group S21 (38.1%, P < 0.01). A significant decrease in thyroglobulin antibody titers was only noted in group S2 (5.2%, P < 0.01). L-selenomethionine substitution suppresses serum concentrations of TPOAb in patients with AIT, but suppression requires doses higher than 100 microg/day which is sufficient to maximize glutathione peroxidase activities. The suppression rate decreases with time.
Posted by valene on April 2, 2007, at 14:40:40
In reply to Re:Head Is Swimming, posted by Phillipa on April 1, 2007, at 17:53:09
(((((((( Phillipa ))))))))
I have been off line for a couple days and just found this thread. I do agree with Quintal about the benzo w/d - being med sensitive myself I can tell if I even cut out a tiny bit of benzo - get all tense and can't think straight.
Also you liked this new pdoc, remember, he is holistic, people come from out of state to see him, that's what you said.....so why not give him more of a chance to treat you? I think he is really trying to do the right thing by you. Going back to the old pdoc, again I agree that is not such a good idea. Luvox in the dosage you were on is *not* therapeutic.
It is so hard right now with all these opinions coming at you but you did get some good suggestions. Please keep on an even benzo dose, that's important rather than going up and down. Believe me and Quintal on that one.
Racer had some very good thoughts too. Best wishes, Phillipa,
Love,
Valene
Posted by Phillipa on April 2, 2007, at 19:23:34
In reply to Re: Betrayed and put into what type of condition? » Phillipa, posted by Larry Hoover on April 2, 2007, at 12:18:29
Lar you're unbelieveable. You said you would find the answer and you did. I thought lithium was bad for the thyroid and that selenium could cause Cancer. I've never even had a scan and all any doc or endo has done is feel it as there is no goiter. I'm having Greg print out the info for both docs. That would also explain why motrin at night seems to help me sleep. And I'm taking ca/mg but how much should I take? And 125mg of magnesium for bowel function. And that explains why this am I woke with the sweating, chest pain, twitching, and had to get an EKG and the internist said it was anxiety. And why I feel cold during the day and then hot very hot at bedtime. And this event today happened about 5hours into sleep with unbelievable 20mg of valium on board and .5 of xanax and 3mg of lunesta. Needless to say I've been couch bound all day and still breathless with exertion. And my ANA last time checked was low for me at l:160 and usually runs between that and l:320. When lymes was very active my ANA was 2800 and something. With all these med changes my thyroid must be confused as I am and bloodwork due tomorrow. But the endo wouldn't listen to the pdoc. And a Charge Nurse my age about in the ER said she has been here 24years and hates all the endos and had her internists treat her thyroid. But we called hers and he's full. Love Jan kisses and hugs to you.
Posted by Phillipa on April 2, 2007, at 19:27:41
In reply to Re:Head Is Swimming » Phillipa, posted by valene on April 2, 2007, at 14:40:40
Valene yes Racer sure did and I've taken a lot of them. Told the PHD that we needed to work on my fear of meds today after the incident above in my response to Lar. What I found out from Greg is that this pdoc isn't the wholistic one like I thought. He was recommended by the PHD for med sensitive people. I won't repeat a lot of what I posted to Lar. Love Jan
Posted by Larry Hoover on April 5, 2007, at 7:20:12
In reply to Re: Betrayed and put into what type of condition? » Larry Hoover, posted by Phillipa on April 2, 2007, at 19:23:34
> Lar you're unbelieveable. You said you would find the answer and you did.
I appreciate your faith in me, but only you can determine if the information feels right for you. I'm really asking questions when I post the information I find.....I don't know that it applies, or not. I hear you saying it *does* fit, and for that, I am quite happy.
> I thought lithium was bad for the thyroid and that selenium could cause Cancer.
Yes, lithium can stress the thyroid. Selenium, on the other hand, is totally essential to thyroid function. Without selenium and iodine, you thyroid cannot function at all. And, quite contrary to your belief, selenium supplementation is associated with a reduction in the incidence of cancer.
It's not known why selenium supplementation reduces the titer of circulating thyroid autoantibodies, but it clearly does so. Low selenium is also associated with depression, and anxiety. Really, you can only find potential benefits if you start taking 200 mcg/day selenium.
> I've never even had a scan and all any doc or endo has done is feel it as there is no goiter.
You never had a needle biopsy? Antibody titres are only presumptive of Hashimoto's. Lymphocyte infiltration of the gland is the definitive diagnostic test. Not that it matters now. I'm quite sure you have it.
> I'm having Greg print out the info for both docs. That would also explain why motrin at night seems to help me sleep.
Any anti-inflammatory would help acute thyroiditis. You don't even need to discuss this with your doctors, you know? Why complicate things. You know when you need it.
> And I'm taking ca/mg but how much should I take? And 125mg of magnesium for bowel function.
I think you're doing okay there. Just make sure you're getting sufficient vitamin D. The uptake pumps require it. For Ca/Mg, intake does not equal uptake, absent vitamin D.
> And that explains why this am I woke with the sweating, chest pain, twitching, and had to get an EKG and the internist said it was anxiety.
Those symptoms are consistent with acute thyroiditis, yes. They are also consistent with myocardial infarction. An EKG was warranted. I hope you found the results of some comfort.
> And why I feel cold during the day and then hot very hot at bedtime.
Now, you can take some control over the situation, by taking some selenium, and treating your symptoms with anti-inflammatories. You don't need a doctor for everything.
> And this event today happened about 5hours into sleep with unbelievable 20mg of valium on board and .5 of xanax and 3mg of lunesta. Needless to say I've been couch bound all day and still breathless with exertion.
That's likely due to the adrenal effects of the brief thyroid storm. You may find some relief from 2000 mg vitamin C, and/or niacinamide (up to 500 mg).
> And my ANA last time checked was low for me at l:160 and usually runs between that and l:320. When lymes was very active my ANA was 2800 and something.
ANA is non-specific, but it does suggest that general inflammation is low. That doesn't mean your thyroid isn't being targetted, only that your systemic inflammation is getting down. That's a good sign.
> With all these med changes my thyroid must be confused as I am and bloodwork due tomorrow. But the endo wouldn't listen to the pdoc. And a Charge Nurse my age about in the ER said she has been here 24years and hates all the endos and had her internists treat her thyroid. But we called hers and he's full. Love Jan kisses and hugs to you.
Your endo, if he's like most endos, was trained in a very rigid philosophy. They target normal blood tests, rather than normalization of symptoms. You don't have to do more than tolerate the guy. Trust your instincts, 'kay?
Best,
Lar
Posted by Phillipa on April 5, 2007, at 19:26:35
In reply to Re: Betrayed and put into what type of condition? » Phillipa, posted by Larry Hoover on April 5, 2007, at 7:20:12
Larry I take 2000mg daily of ester C. And a plant based multi. So the selenium isn't adequate? I must be having these storms nightly as it's on going with nightmares. When I picked up the two serzone pills the printout said no motrin or nsaids. Also cautioned about the benzos the pdoc said only xanax he was mistaken as it says all benzos and sleep meds. Is lunesta included in this category of what they give no examples of sleep meds? I have been in all day on the computer. Whooped. So I haven't gotten selenium yet. Love Jan ps also still on the incredible dose of valium he said to take. I've wondered if it could be a paradoxical reaction to valium too as I take over the course of the night 30mg. Just for a few hours of sleep. No deep sleep apparantly.
Posted by gardenergirl on April 6, 2007, at 12:29:35
In reply to Re: Betrayed and put into what type of condition? » Larry Hoover, posted by Phillipa on April 5, 2007, at 19:26:35
Hi Phillipa,
According to Epocrates http://www.epocrates.com/ Serzone increases the level of Xanax, which could result in CNS depression or toxicity due to inhibited liver metabolism. They recommend cutting the Xanax dose in half if you take Serzone with it.With Valium and Serzone (nefazodone), it MAY increase the Valium levels, and if so results in similar effects as above.
With Lunesta it's reommended to start at 1 mg and then increase to 2 mg, since Serzone can also increase levels of this drug and can affect liver metabolism.
Incidentally, they also recommend caution when using Lunesta and a benzo due to the additive effects increasing the risk of CNS depression.
I put Vitamin C, selenium, and Motrin in the mix, as well, and none of these came back with any issues with any of the other meds: Lunesta, Serzone, Valium, or Xanax. So as far as Epocrates is concerned, there are no harmful interactions with those.
Oh, and btw, Motrin makes me sleepy, too. It's a known side effect. If I have to take a prescription level dose, (I'm allergic to sulfa type NSAIDs), I not only get sleepy, I also retain fluids and get puffy. Bleah. But...eventual pain relief from an injury is worth it.
Hope this helps.
namaste
gg
Posted by Phillipa on April 6, 2007, at 20:56:56
In reply to Med interactions » Phillipa, posted by gardenergirl on April 6, 2007, at 12:29:35
GG thanks for explanation see my serzone thread. Last post. And didn't sleep on two lunesta and 30mg of valium answer in serzone thread. Love Phillipa
Posted by Larry Hoover on April 8, 2007, at 9:44:57
In reply to Re: Betrayed and put into what type of condition? » Larry Hoover, posted by Phillipa on April 5, 2007, at 19:26:35
> Larry I take 2000mg daily of ester C. And a plant based multi. So the selenium isn't adequate?
I can't tell, from here. Only you know have the info about what you swallow. How much selenium is in the multi? The "official" UL for selenium intake is 400 mcg/day, so rest assured that I'm not pushing any absurd intake level on you. It's just that your thyroid is under incredible stress because of autoimmune activation, and you can ease its functioning with selenium intake. Selenium is even more essential than iodine, in one respect, as the enzymes that manipulate the iodine all are structurally dependent on selenium.
> I must be having these storms nightly as it's on going with nightmares.
I was suggesting acute episodes of thyroiditis as an explanation for the occasional severe symptoms which sent you to the emergency room, not the day-to-day sleep disturbances. Have I misunderstood? Most nights, it's the same thing over and over, but once in a while, you have a real horrible physical reaction, right?
> When I picked up the two serzone pills the printout said no motrin or nsaids.
I don't understand that. I read the entire drug monograph, and found no similar warning. Ibuprofen is a substrate for 2C9, so it is unaffected by Serzone (i.e. no metabolic interaction).
> Also cautioned about the benzos the pdoc said only xanax he was mistaken as it says all benzos and sleep meds.
There's strong evidence that Xanax metabolism is directly affected by Serzone, with lesser evidence of a similar interaction with other classes of benzos. That's metabolic interaction. A separate issue is what is called synergism, where two drugs have similar functional effects. The sedation from one drug can add substantially to that of another, even though they might work by different mechanisms. Someone combining these drugs needs to be aware that they might become literally impaired by the meds.
> Is lunesta included in this category of what they give no examples of sleep meds?
Yes, because of potential additive or synergistic functional effects.
> I have been in all day on the computer. Whooped. So I haven't gotten selenium yet. Love Jan ps also still on the incredible dose of valium he said to take. I've wondered if it could be a paradoxical reaction to valium too as I take over the course of the night 30mg. Just for a few hours of sleep. No deep sleep apparently.
The monograph for Valium gives dosing of up to 40 mg/day. That's what you're getting, right?
I know how incredibly difficult this would be, but your unusual (lack of) response to the high dosing might indicate that your body has developed some adaptation to block this chronic exposure. If so, the only option is to taper off completely, and then wait for everything to settle down. Like I just went through.
Lar
Posted by Fivefires on April 8, 2007, at 16:22:17
In reply to Re: Betrayed and put into what type of condition? » Larry Hoover, posted by Phillipa on April 5, 2007, at 19:26:35
Phillipa
Would just like to add ... 'trazodone' had always caused me to have bad nightmares. One of my reasons for not beginning it yet again.
I'm under the impression your nbad nightmares began when u started the Serzone. Is that correct?
5f
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.