When Is It Too Much?

[PTSDbegone]

Thank you kindly, I have questioned my regular doctor about it, and I am currently going to slowly come off of the Celexa.

Thanks so much for all the information.

 

[Ivan the Elder]

You are very welcome. I am very pleased to be of help. I hope you feel better soon. I am pretty sure you will.

 

[PTSDbegone]

Again I have had a change in medication. I often wonder if any of it actually helps.

Currently on 200mg of Seroquel
80mg of Prozac
.4mg of Clonidine

Again not sure if this is too much. It feels like it's too much. Going back to the Psychiatrist on Wednesday, but I feel it's getting to be too much.

 

[Ivan the Elder]

All I can say is to follow your doctors advice. At least what you are taking now is safer. Reducing your medication should be a joint decision. Some doctors don't like the patient to be a part of their own medical care. I very much disagree with that. If that is how it seems then look for a doctor that will work with you, not just on you.

 

[PTSDbegone]

Thank you very much @Evan

 

[PTSDbegone]

Goodness went to see the Psychiatrist today and again my meds have been changed. Clonidine has been lowered, and I am going back on the Prazosin.

 

[Ivan the Elder]

Give it a month before you make any decision otherwise. It takes time for drug changes to stabilize in your body. That especially applies to antidepressants. Also, most drugs interact with each other in some way. This is becoming a huge issue that even quite recently was not well understood. With the information now available from the Human Genome Project many previously unknown interactions are being found. Drug to Drug Interactions (DDIs) are now the rule, not the exception. This also applies strongly to non approved herbal products. Some types interact with over half the drugs on the market and that is thousands. Even plain grapefruit juice will interact with up to 43 known drugs, some bad enough to be lethal. This is why you must see your doctor. Also, make sure you tell the doctor about any and everything you are taking, prescribed or not. Even talk about your diet, if the doctor knows much in that area. Many do not.

Until very recently nutrition wasn't even a part of regular med school. That is now changing.

 

[PTSDbegone]

@Evan Thank you for that. I am glad to hear that things are changing. Nutrition is so important.

Thanks for all the information. Again I've had a change. I have added Naltraxone to the mix for dissociation. So far haven't noticed any improvement. Just a lot of stomach upset and vomiting.

 

[Ivan the Elder]

Naltraxone? Are you taking any sort of medication that contains over the counter codeine? That isn't available in the US but it is in Canada. If you are then the Naltraxone will cancel the effect of the codeine. That is the primary use of NaItraxone, it is an antidote for heroin/morphine overdose. I have just run into that problem myself. About a month ago I started taking Oxazepam which is a benzodiazepine used as a sleeping med. I also take heavy dose codeine in part for fibro pain but much more important because it ups my dopamine which is usually very low and especially because it helps control my norepinephrine release/reuptake failure. Codeine changes metabolically to about 10% morphine and that then acts the same as any other morphine does.

The last few weeks my Doc and I decided to up the Oxazepam because it is also a decent anxiety med, which I really need right now. This last few weeks I have been feeling worse and worse and have had to up my codeine almost to max allowed. I have permission from my doc to adjust my dosage because he knows I know what is safe and what is not.

The problem is that it is increasing the amount of codeine my liver must deal with to a level I don't like and I am not yet on treatment (that's another story). So, time to do some research. It turns out that even though it isn't listed Oxazepam uses the exact same enzymes in the liver for metabolism as does Codeine. It has been inactivating up to half my normal codeine dose. That is why I have had to up the dose a lot. I see my Doc tomorrow and I am going to get him to switch me to straight fast acting morphine. That is 1/10th the amount of drug for the same effect and it doesn't need to be metabolised since it is already morphine. Then I can take the Oxazepam without it cancelling the codeine/morphine effect. That will up my dopamine and reduce the free norepinephrine and I should feel far better.

 

[Ivan the Elder]

You and I both misspelled the drug name. It is Naltrexone. In low doses it also stabilizes your immune system.

 

[PTSDbegone]

More changes.. I am going to start coming off of the Prozac, and I am adding Remeron.

My regular GP just sent in a referral today so I could have a medication consultation through a local hospital as part of their trauma therapy program. Nothing so far seems to have made a difference, and I am so tired of all these appointments. When I first started dealing with my past I hesitated taking one medication, but now being on 4 seems to be too much.