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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by parkscat on January 28, 2009, at 9:25:26
I am on 100mg Seroquel at night, 100mg Zoloft at night and in morning and 100mg Lamictal at night. Have some Klonopin for when chest is real anxious. I can't relax or get excited about anything like I did with the ups and downs I had before. Help!
Posted by SLS on January 28, 2009, at 9:37:42
In reply to I need advice on anxious depression., posted by parkscat on January 28, 2009, at 9:25:26
> I am on 100mg Seroquel at night, 100mg Zoloft at night and in morning and 100mg Lamictal at night. Have some Klonopin for when chest is real anxious. I can't relax or get excited about anything like I did with the ups and downs I had before. Help!
Do you wake up during the middle of the night? How is your level of anxiety when you do?
- Scott
Posted by parkscat on January 28, 2009, at 9:42:48
In reply to Re: I need advice on anxious depression., posted by SLS on January 28, 2009, at 9:37:42
I have no real anxiety at night. If I try to nap in daytime I feel like crawling out of my skin and full of guilt. I sleep ok on 100mg or Seraquel but better if I add something to it. I wake up and within an hour the anxious chest starts. I don't want to take a chill pill but sometimes its all that calms me down so I can work. Danny
Posted by SLS on January 28, 2009, at 10:02:24
In reply to Re: I need advice on anxious depression., posted by parkscat on January 28, 2009, at 9:42:48
> I have no real anxiety at night. If I try to nap in daytime I feel like crawling out of my skin and full of guilt. I sleep ok on 100mg or Seraquel but better if I add something to it. I wake up and within an hour the anxious chest starts. I don't want to take a chill pill but sometimes its all that calms me down so I can work. Danny
Perhaps you should take Seroquel 200-300mg per day. You can start with adding 100mg in the morning. How would you present this idea to your doctor?
- Scott
Posted by parkscat on January 28, 2009, at 10:05:45
In reply to Re: I need advice on anxious depression., posted by SLS on January 28, 2009, at 10:02:24
He already said 200 at night was worth trying but I am nervous about it.
Posted by SLS on January 28, 2009, at 10:17:49
In reply to Re: I need advice on anxious depression., posted by parkscat on January 28, 2009, at 10:05:45
> He already said 200 at night was worth trying but I am nervous about it.
It sounds like there is very little that you are not nervous about. Not your fault, of course. It's the illness talking.
What exactly are you nervous about? You might have some very valid reasons.
- Scott
Posted by parkscat on January 28, 2009, at 10:24:25
In reply to Re: I need advice on anxious depression. » parkscat, posted by SLS on January 28, 2009, at 10:17:49
Doc said I have an Anxiety Disorder so everything or anything can trigger it. My main concern right now is a teenage daughter who is not motivated to find a job and she starts school in two weeks and I am concerned she will give it up soon after she starts. I have OCD just the thoughts not the actions so it is a constant battle in my head. Even my faith in Christ gets attacked constantly. Guess I am just broke and no one knows how to fix me. Danny
Posted by SLS on January 28, 2009, at 10:35:03
In reply to Re: I need advice on anxious depression., posted by parkscat on January 28, 2009, at 10:24:25
> Even my faith in Christ gets attacked constantly.
Depression can squelch spirituality or test faith with intrusive melancholy thoughts. Anxiety can add to this, and make things seem unreal.
> Guess I am just broke and no one knows how to fix me.
No way, Danny! There are just too many treatments available for you to give up at this point.
I still wonder if, based upon your pattern of anxiety throughout the day, taking 100mg of Seroquel in the morning might be helpful. Maybe 200mg at night and 100mg in the morning would be most productive.
- Scott
Posted by Phillipa on January 28, 2009, at 10:38:01
In reply to Re: I need advice on anxious depression., posted by parkscat on January 28, 2009, at 10:24:25
Your story kind of reminds me of mine it's such a viscious cycle. Has your doc said you have GAD or panic attacks related to life events? As seems that when life is smooth not often this symtom goes away. Do you feel depressed. Like not doing things etc or doing too much and guilt if you don't accomplish your goal and no satisfaction if you do? Love Phillipa and if new welcome
Posted by parkscat on January 28, 2009, at 10:43:14
In reply to Re: I need advice on anxious depression. » parkscat, posted by SLS on January 28, 2009, at 10:35:03
Will I be a Zoombie taking it in the morning? Danny
Posted by parkscat on January 28, 2009, at 10:45:49
In reply to Re: I need advice on anxious depression. » parkscat, posted by Phillipa on January 28, 2009, at 10:38:01
You got me pegged. Sometimes life can be a wreck and no stress. Other times I feel like coming out of my skin. I hate to plan things in the future because I don't know which mood I will be in that week. Danny
Posted by SLS on January 28, 2009, at 11:13:29
In reply to Re: I need advice on anxious depression., posted by parkscat on January 28, 2009, at 10:43:14
> Will I be a Zoombie taking it in the morning? Danny
Not once the dosage is high enough. Seroquel turns into something called norquetiapine in the body. This is also an active drug (metabolite) that has antidepressant properties. It tends to be energizing for many people. The higher the dosage of Seroquel, the more norquetiapine is formed.
There is no guarantee that you will react to Seroquel this way. Perhaps you should follow your doctor's suggestion and try 200mg at night. Then, if you tolerate it well, you can then try adding 100mg in the morning. After the dosage increase, wait a few days before passing judgment on the "zombie" thing. Give the levels of norquetiapine a chance to build up (if this is indeed the mechanism behind the biphasic sleep-inducing / energizing phenomenon).
- Scott
Posted by bleauberry on January 28, 2009, at 16:24:49
In reply to I need advice on anxious depression., posted by parkscat on January 28, 2009, at 9:25:26
I guess this all depends on whether this anxiousness was the same or less before the meds. Or before one of the meds. If it at some point got worse than before, then you know it is one of the meds. If on the other hand it was there before but has not improved with the meds, then logic says they are the wrong meds. If that were the case, Lexapro or Paxil could replace Zoloft. Zyprexa could replace Seroquel. Lamictal itself could be the guilty one. All these things are possibilities but not for sure. That's why it is important to compare how things were before each med to how they are after the med.
Meds can and do cause things to happen that are the opposite of what they are hoped to do. For example, just because Zoloft is generally good for anxiety doesn't mean it won't worsen anxiety for some people or have no effect on reducing anxiety. It is not universally good for anxiety, only generally. Same with the other meds. Even though Seroquel might feel like an elephant dart when you take it, underneath that zombiness it can stir up some inner restlessness.
So I guess what I'm saying is it might be good to take a close look at the meds and see if you can point a finger at any of them. If not, then a dosage change may be in order. Maybe down on Zoloft, up on Seroquel, not sure about Lamictal.
Posted by SLS on January 28, 2009, at 16:52:30
In reply to Re: I need advice on anxious depression., posted by bleauberry on January 28, 2009, at 16:24:49
> I guess this all depends on whether this anxiousness was the same or less before the meds. Or before one of the meds. If it at some point got worse than before, then you know it is one of the meds. If on the other hand it was there before but has not improved with the meds, then logic says they are the wrong meds. If that were the case, Lexapro or Paxil could replace Zoloft. Zyprexa could replace Seroquel. Lamictal itself could be the guilty one. All these things are possibilities but not for sure. That's why it is important to compare how things were before each med to how they are after the med.
>
> Meds can and do cause things to happen that are the opposite of what they are hoped to do. For example, just because Zoloft is generally good for anxiety doesn't mean it won't worsen anxiety for some people or have no effect on reducing anxiety. It is not universally good for anxiety, only generally. Same with the other meds. Even though Seroquel might feel like an elephant dart when you take it, underneath that zombiness it can stir up some inner restlessness.
>
> So I guess what I'm saying is it might be good to take a close look at the meds and see if you can point a finger at any of them. If not, then a dosage change may be in order. Maybe down on Zoloft, up on Seroquel, not sure about Lamictal.
Excellent post.What would you do first?
- Scott
Posted by Neal on February 7, 2009, at 10:46:11
In reply to Re: I need advice on anxious depression. » bleauberry, posted by SLS on January 28, 2009, at 16:52:30
"I hate to plan things, because I don't know how I'll feel"
Man, that's the worst thing about this illness. I so empathize with you on that. Interferes with your personal life, your work, whatever. That, in my opinion is the cause of a lot of the anxiety for lots of people with the illness.
I have a few tricks to deal with it, but sometimes (rarely) you just have to cancel things cause it's not gonna work that day.
This is the end of the thread.
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