Comments for The Sidewalk Psychiatrist http://thesidewalkpsychiatrist.wordpress.com Practical answers to mental health questions Mon, 08 Sep 2008 13:34:35 +0000 http://wordpress.org/?v=MU hourly 1 Comment on Tapering Lamictal by doctordan http://thesidewalkpsychiatrist.wordpress.com/2007/07/15/tapering-lamictal/#comment-2300 doctordan Mon, 01 Sep 2008 13:57:46 +0000 http://thesidewalkpsychiatrist.wordpress.com/2007/07/15/tapering-lamictal/#comment-2300 D-- See the article dated Sept 1, 2008. --DH MD D–

See the article dated Sept 1, 2008.

–DH MD

]]> Comment on Tapering Lamictal by D http://thesidewalkpsychiatrist.wordpress.com/2007/07/15/tapering-lamictal/#comment-2298 D Sun, 31 Aug 2008 17:39:11 +0000 http://thesidewalkpsychiatrist.wordpress.com/2007/07/15/tapering-lamictal/#comment-2298 Dear Dr. Dan, I'm a 45 y/o female properly diagnosed and treated as bipolar for 1 & 1/2 years. Prior to this diagnosis, I was treated soley for depression for 10 years (the last 5 as refractory.) I am presently doing GREAT on Lamictal 200mg daily and Effexor 300mg daily. The problem? I've had a rash on my leg for 2 weeks and only today made the connection to Lamictal's potential for a life-threatening rash. I can rule out contact dermatitis. I'm not experiencing SJS symptomes. I will contact my ANP on Tuesday for evaluation and probably drug dicontinuation. My question? What titration schedule do you use to discontinue Lamictal? What titration schedule do you use to concurrently add another AED such as Topamax? I really appreciate your time and dedication to this topic! Have you had particular success with another AED? I can't begin to tell you how well I have been doing since the addition of Lamictal. It changed my life. I hate to give it up. Dear Dr. Dan,
I’m a 45 y/o female properly diagnosed and treated as bipolar for 1 & 1/2 years. Prior to this diagnosis, I was treated soley for depression for 10 years (the last 5 as refractory.) I am presently doing GREAT on Lamictal 200mg daily and Effexor 300mg daily. The problem? I’ve had a rash on my leg for 2 weeks and only today made the connection to Lamictal’s potential for a life-threatening rash. I can rule out contact dermatitis. I’m not experiencing SJS symptomes. I will contact my ANP on Tuesday for evaluation and probably drug dicontinuation. My question? What titration schedule do you use to discontinue Lamictal? What titration schedule do you use to concurrently add another AED such as Topamax? I really appreciate your time and dedication to this topic! Have you had particular success with another AED? I can’t begin to tell you how well I have been doing since the addition of Lamictal. It changed my life. I hate to give it up.

]]> Comment on Lamictal and acne by Dee http://thesidewalkpsychiatrist.wordpress.com/2008/05/14/lamictal-and-acne/#comment-2296 Dee Sat, 30 Aug 2008 00:51:59 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=100#comment-2296 acne on chest every time i go back on lamictal. of course it is related. acne on chest every time i go back on lamictal. of course it is related.

]]> Comment on Vyvanse–new way to deliver an old drug (this one is ok!!!) by jamie http://thesidewalkpsychiatrist.wordpress.com/2007/09/22/vyvanse-new-way-to-deliver-an-old-drug-this-one-is-ok/#comment-2295 jamie Thu, 28 Aug 2008 12:28:08 +0000 http://thesidewalkpsychiatrist.wordpress.com/2007/09/22/vyvanse-new-way-to-deliver-an-old-drug-this-one-is-ok/#comment-2295 I started having panic attacks and was very unsociable and kept to myself,all this started about 10 years ago. The doctors diagnosed me as bipolor,i've been on every med available for bipolar with no positive results. Last december my doc decided to try me on 20 mg 1 a day generic adderral. It turned my life around i was talking to people i had avoided for years and started back doing normal activities instead of cutting myself off from the rest of the world i also was not as angry as before. To start with one a day is all i could handle, it gave me more than enough energy. Now in august i am taking 4 a day and i feel almost like i did before i started taking them. I have severe headaches and mood swings,i also become very angry easily. My doc switched me to vyvanse, i am scared i will fall back in the rut i was in for all those years. Will vyvanse be as good as adderral, and how long should i take it before i notice a change? I wonder if i quit adderral for a couple of months and then start it again , will it give me the affect it originally did? My behavior is affecting my whole life. Is there any advice or anything encouraging you can give me? I started having panic attacks and was very unsociable and kept to myself,all this started about 10 years ago. The doctors diagnosed me as bipolor,i’ve been on every med available for bipolar with no positive results. Last december my doc decided to try me on 20 mg 1 a day generic adderral. It turned my life around i was talking to people i had avoided for years and started back doing normal activities instead of cutting myself off from the rest of the world i also was not as angry as before. To start with one a day is all i could handle, it gave me more than enough energy. Now in august i am taking 4 a day and i feel almost like i did before i started taking them. I have severe headaches and mood swings,i also become very angry easily. My doc switched me to vyvanse, i am scared i will fall back in the rut i was in for all those years. Will vyvanse be as good as adderral, and how long should i take it before i notice a change? I wonder if i quit adderral for a couple of months and then start it again , will it give me the affect it originally did? My behavior is affecting my whole life. Is there any advice or anything encouraging you can give me?

]]> Comment on Lamictal and acne by Mary http://thesidewalkpsychiatrist.wordpress.com/2008/05/14/lamictal-and-acne/#comment-2291 Mary Tue, 26 Aug 2008 16:21:51 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=100#comment-2291 Hello, I hate to say it, but I was relieved to hear that many others reported gettting acne (especially along jawline) from Lamictal. I complained about this to my Psyciatrist, but he said he never heard of that being a side effect. I, also was feeling so blah, lost my self-esteem and confidence to do my job (and quit) and could not get any endorphin release from aerobic exercise, listening to music & playing my trombone. I became so very depressed and stopped doing these activities which have been trustworthy coping strategies (am 47 yrs old). I told this to my Dr. and he insisted that I was not depressed which made me more depressed to have a Dr. who I thought understood me discount my feelings. Anyways, I have gone back to my former psychiatrist (reluctantly b/c have to pay out of pocket) b/c he has known me for almost 3 years and validated that I am depressed. I got off the 200 mg Lamictal within 1.5 weeks which gave me terrible anxiety. I tried Prozac which made it worse and went off of that. Now I have been on 50 mg of zoloft for 2 weeks & still feel depressed. I saw my Dr. today & he told me to bump the dose up to 100 mg and then to add Topomax. I fear adding a second drug especially a mood stabilizer since I had such bad experience with the Lamictal. I just want to be on one drug for now and only to be on an antidepressant for now b/c I have not been in a hypomaniac mood since January. Do you think going off the Lamictal too quickly caused me to go deeper into depression? Do you think I should wait and see if the Zoloft pulls my mood up? I am currently not working b/c of all I mentioned above and can barely take care of myself and my 5 yr. old daughter. People who know me would not recognize me b/c I have always been upbeat, positive and motivated. Now I can barely get up and take my daughter to preschool and then in another week get her off to K-grade. Oh, and yes, I have been getting talk therapy on a weekly basis for the past 4 years. Please advise.....I am in the process of trying to find a Dr. in my insurance network to get another oppinion. Thank you for your assistance....I am desperate! Hello,
I hate to say it, but I was relieved to hear that many others reported gettting acne (especially along jawline) from Lamictal. I complained about this to my Psyciatrist, but he said he never heard of that being a side effect. I, also was feeling so blah, lost my self-esteem and confidence to do my job (and quit) and could not get any endorphin release from aerobic exercise, listening to music & playing my trombone. I became so very depressed and stopped doing these activities which have been trustworthy coping strategies (am 47 yrs old). I told this to my Dr. and he insisted that I was not depressed which made me more depressed to have a Dr. who I thought understood me discount my feelings. Anyways, I have gone back to my former psychiatrist (reluctantly b/c have to pay out of pocket) b/c he has known me for almost 3 years and validated that I am depressed. I got off the 200 mg Lamictal within 1.5 weeks which gave me terrible anxiety. I tried Prozac which made it worse and went off of that. Now I have been on 50 mg of zoloft for 2 weeks & still feel depressed. I saw my Dr. today & he told me to bump the dose up to 100 mg and then to add Topomax. I fear adding a second drug especially a mood stabilizer since I had such bad experience with the Lamictal. I just want to be on one drug for now and only to be on an antidepressant for now b/c I have not been in a hypomaniac mood since January. Do you think going off the Lamictal too quickly caused me to go deeper into depression? Do you think I should wait and see if the Zoloft pulls my mood up? I am currently not working b/c of all I mentioned above and can barely take care of myself and my 5 yr. old daughter. People who know me would not recognize me b/c I have always been upbeat, positive and motivated. Now I can barely get up and take my daughter to preschool and then in another week get her off to K-grade. Oh, and yes, I have been getting talk therapy on a weekly basis for the past 4 years. Please advise…..I am in the process of trying to find a Dr. in my insurance network to get another oppinion. Thank you for your assistance….I am desperate!

]]> Comment on Combining Lamictal with Birth Control Pills by Joanna http://thesidewalkpsychiatrist.wordpress.com/2007/06/30/combining-lamictal-with-birth-control-pills/#comment-2290 Joanna Tue, 26 Aug 2008 05:53:06 +0000 http://thesidewalkpsychiatrist.wordpress.com/2007/06/30/combining-lamictal-with-birth-control-pills/#comment-2290 I am 20 and I would like to go on birth control. im taking 150 mg of lamictal for my epilepsy and was wondering if birth control meds will affect my siezures, or if the Lamictal will affect the birth control at all. Do you know what type of birth control (brand) works best when combined with Lamictal? And do I need to use a higher dose of birth control so that it is more effective? I am 20 and I would like to go on birth control. im taking 150 mg of lamictal for my epilepsy and was wondering if birth control meds will affect my siezures, or if the Lamictal will affect the birth control at all. Do you know what type of birth control (brand) works best when combined with Lamictal? And do I need to use a higher dose of birth control so that it is more effective?

]]> Comment on Another Klonopin Horror Story . . . why do I prescribe this stuff anyway??? by doctordan http://thesidewalkpsychiatrist.wordpress.com/2008/08/20/another-klonopin-horror-story-why-do-i-prescribe-this-stuff-anyway/#comment-2289 doctordan Sat, 23 Aug 2008 02:02:25 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=134#comment-2289 Ron-- Excellent reply. I'm glad to pass along a positive story about Klonopin. I agree with all my patients that don't want to be on medicine. In fact, I think that some (especially adolescents) are taken aback when I tell them that I don't want them to want to see me or to take the medicine. "Wanting to" is optional. It is about deciding what is best for you so that you can lead a full and happy life. Klonopin is a great medicine when used with the proper precaution and discretion. And, yes, i do believe you are correct . . . and you get the 10 points! --DH MD Ron–

Excellent reply. I’m glad to pass along a positive story about Klonopin. I agree with all my patients that don’t want to be on medicine. In fact, I think that some (especially adolescents) are taken aback when I tell them that I don’t want them to want to see me or to take the medicine. “Wanting to” is optional. It is about deciding what is best for you so that you can lead a full and happy life. Klonopin is a great medicine when used with the proper precaution and discretion.

And, yes, i do believe you are correct . . . and you get the 10 points!

–DH MD

]]> Comment on Tapering quickly off Klonopin . . . or . . . how to drive yourself crazy and feel like crap by Leslie http://thesidewalkpsychiatrist.wordpress.com/2008/08/07/tapering-quickly-off-klonopin-or-how-to-drive-yourself-crazy-and-feel-like-crap/#comment-2288 Leslie Fri, 22 Aug 2008 16:06:38 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=123#comment-2288 I've been off klonopin for three weeks after a slow and gradual decrease. I have been taking 2mg a day for 1 year. I still had a hard time, praying to the porcelaine goddess, shaking, insomnia...etc, I can't imagine 15 years! I know I will never ever ever touch another benzo for as long as I live. I'm finally starting to feel "normal" again. Goodluck to everyone trying to get off this drug. I’ve been off klonopin for three weeks after a slow and gradual decrease. I have been taking 2mg a day for 1 year. I still had a hard time, praying to the porcelaine goddess, shaking, insomnia…etc, I can’t imagine 15 years! I know I will never ever ever touch another benzo for as long as I live. I’m finally starting to feel “normal” again.

Goodluck to everyone trying to get off this drug.

]]> Comment on Another Klonopin Horror Story . . . why do I prescribe this stuff anyway??? by Ron http://thesidewalkpsychiatrist.wordpress.com/2008/08/20/another-klonopin-horror-story-why-do-i-prescribe-this-stuff-anyway/#comment-2286 Ron Thu, 21 Aug 2008 13:38:56 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=134#comment-2286 Quote: So why do I prescribe it??? Because it works. ------------------ That's right. I've been taking .5 to 1 mg. Clonazepam as needed for about 3 years because of essential tremor and it has made a tremendous difference in my life. Before starting the medication, the tremors prevented me from writing or typing. I get very tired of reading that "this is a terrible drug" and "it should be banned!!". Also some doctors are very reluctant to prescribe this medication. After moving to a different state, a new doctor emphatically told me that "this medication should not be taken for more than a few weeks!". I do understand a patients desire to stop taking a medication. I also wish I didn't have to depend on this medication. But, there's not much choice. I wish your patient well. By the way, was "I'm dancing as fast as I can" by Barbara Gordon the book you're referring to? Do I get 10 points? Quote:
So why do I prescribe it???
Because it works.
——————

That’s right. I’ve been taking .5 to 1 mg. Clonazepam as needed for about 3 years because of essential tremor and it has made a tremendous difference in my life. Before starting the medication, the tremors prevented me from writing or typing. I get very tired of reading that “this is a terrible drug” and “it should be banned!!”. Also some doctors are very reluctant to prescribe this medication. After moving to a different state, a new doctor emphatically told me that “this medication should not be taken for more than a few weeks!”. I do understand a patients desire to stop taking a medication. I also wish I didn’t have to depend on this medication. But, there’s not much choice.

I wish your patient well.

By the way, was “I’m dancing as fast as I can” by Barbara Gordon the book you’re referring to? Do I get 10 points?

]]> Comment on Tapering quickly off Klonopin . . . or . . . how to drive yourself crazy and feel like crap by Katey http://thesidewalkpsychiatrist.wordpress.com/2008/08/07/tapering-quickly-off-klonopin-or-how-to-drive-yourself-crazy-and-feel-like-crap/#comment-2282 Katey Tue, 19 Aug 2008 02:05:50 +0000 http://thesidewalkpsychiatrist.wordpress.com/?p=123#comment-2282 Dawn, Trust me! You don't want to go through withdrawals from any medication without a physician's assistance. You can end up having a heart attack, stroke, not to mention how incredibly uncomfortable you feel. I was on prescription opiates for about 2 years and the first attempt to stop was catastrophic. I had 2 strokes and many seizures. Definitely call your doctor and let him/her know what you are doing. They can prescribe a non-narcotic that will help you and keep your heart rate in check. The one that was given to me was Clonodine. Propanolol also helps keep the edge off. GOOD LUCK TO YOU!!!! And as everyone here says, going cold turkey can cost you your life. Just like weight loss......slower is healthier. Take care and our thoughts and prayers are with you. Katey Dawn, Trust me! You don’t want to go through withdrawals from any medication without a physician’s assistance. You can end up having a heart attack, stroke, not to mention how incredibly uncomfortable you feel. I was on prescription opiates for about 2 years and the first attempt to stop was catastrophic. I had 2 strokes and many seizures.

Definitely call your doctor and let him/her know what you are doing. They can prescribe a non-narcotic that will help you and keep your heart rate in check. The one that was given to me was Clonodine. Propanolol also helps keep the edge off.

GOOD LUCK TO YOU!!!! And as everyone here says, going cold turkey can cost you your life. Just like weight loss……slower is healthier.

Take care and our thoughts and prayers are with you.

Katey

]]>