bluelikejazz Posted October 1, 2012 Share Posted October 1, 2012 It only started once I put up the dose of the lithium, but it's unlikely to be causing this much sedation. I'm wondering if it's interaction with the Jurnista (slow release hydromorphine) and increasing the sedation, but I've started taking it at night and haven't noticed a change. It's a the stage where I'm concerned about driving and I don't have a psychiatrist (despite me trying hard!) so I've reduced the seroquel to 200mg. I was placed on that much seroquel XR when I had a severe spike in PTSD symptoms which have now completely subsided, so I'm not really anxious anymore. I'll speak to my GP tomorrow about it, but I was wondering if anybody had any feedback. I'm also on celebrex and nexium but I doubt they are doing anything. Link to comment Share on other sites More sharing options...
Cetkat Posted October 14, 2012 Share Posted October 14, 2012 Did you ever find out anything from the GP? Link to comment Share on other sites More sharing options...
melissaw72 Posted October 16, 2012 Share Posted October 16, 2012 Would hydromorphine cause the sleepiness? I had that after surgeries (morphine) and it caused me to be very sleepy. Link to comment Share on other sites More sharing options...
bluelikejazz Posted October 16, 2012 Author Share Posted October 16, 2012 The GP said "Let me look at your meds...I don't know. You have lots that make you sleepy. You really need a psychiatrist..." So no. It could be the hydromorphine, but it could be other meds too. Link to comment Share on other sites More sharing options...
AirMarshall Posted October 16, 2012 Share Posted October 16, 2012 Well let's stop beating around the bush. Of course the primary suspect is hydromorphone! I would put Seroquel up second, with Lithium in third. They are all sedating to a degree, and the effects are additive. Now: let me throw in a physical problem resulting from the sedation: Sleep apnea and/or snoring. All that relaxation can cause tongue and throat muscles to relax during sleep causing reduced sleep quality from sleep disturbances, apnea or hypoxia. This can wreck your sleep and cause all sorts of daytime problems. Just one more aspect to consider. a.m. Link to comment Share on other sites More sharing options...
Guest Posted October 16, 2012 Share Posted October 16, 2012 I'm with AirMarshall on this one. My guesses would be exactly the same:hydromorphoneSeroquelLithium Do you wake up feeling worse than when you went to bed? If so then sleep apnea may very well be part of the problem. It's fixed fairly easily most times. You do a sleep study and get a CPAP machine. Mine made a world of difference. Link to comment Share on other sites More sharing options...
Cetkat Posted October 17, 2012 Share Posted October 17, 2012 Well, my curiosity stems from whether lithium really has a big enough effect for it to be additive. The sleep idea makes more sense to me. I also wonder, given the "hydro" portion being a reference to its release method, if a change in water/salt balance could have an effect on release rate. I wasn't able to go very far with that line of thinking though. Link to comment Share on other sites More sharing options...
bluelikejazz Posted October 17, 2012 Author Share Posted October 17, 2012 Thanks guys, It's annoying because my pain and mood are the best managed they have been for years. I don't think its sleep apnea. When I was inpatient they universally screen for sleep apnea, and I didn't have any of the risk factors/symptoms. I don't snore and I feel quite refreshed when I wake up, it's around lunchtime that I get really fatigued and it lasts until about 8pm. Cetkat, so you're thinking more water would help? I'm on lithium so I'm meant to be drinking lots anyway. Link to comment Share on other sites More sharing options...
Cetkat Posted October 17, 2012 Share Posted October 17, 2012 Cetkat, so you're thinking more water would help? I'm on lithium so I'm meant to be drinking lots anyway. No idea. Like I said, I didn't get very far.. I'm wondering if the pain med being extended release may be getting released a bit too much at one time. A pharmacist may be able to give you some guidance on that. However, water is always a good idea. Dehydration can make you tired too, so upping it a bit doesn't seem like a bad idea. Link to comment Share on other sites More sharing options...
melissaw72 Posted October 17, 2012 Share Posted October 17, 2012 Cetkat, so you're thinking more water would help? I'm on lithium so I'm meant to be drinking lots anyway. No idea. Like I said, I didn't get very far.. I'm wondering if the pain med being extended release may be getting released a bit too much at one time. A pharmacist may be able to give you some guidance on that. However, water is always a good idea. Dehydration can make you tired too, so upping it a bit doesn't seem like a bad idea. Too much water isn't good for your kidneys though. Especially because you are on Lithium. Idk specifically why, just know there is a way people have "drowned out" their kidneys (I know I have read this at sometime in my life somewhere on a message board b/c when I did I made sure I didn't drink as much as I was. I was just more conscious about it). Link to comment Share on other sites More sharing options...
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