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CT'd Lamictal, Trileptal, and Seroquel


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Finally decided I have to ask for any similar experiences, knowledge, any comments. I 'll try to keep this short and sweet but I am not known for my ability to get to the point and my brain is foggy at best right now. I have read the thread about why you don't stop taking ACs cold turkey but pdoc ordered me too, in fact this is the second time.

I have had problems with orthostatic hypotension ever since I reached 200mg Seroquel. I have passed out and hit my head five times now. Last weekend was the worse fall and the most painful. As a result, pdoc cold-turkeyed me off 300mg Lamictal, 300 mg Trilpetal, and 400mg Seroquel. Within 24 hours I was very sick. Upper and lower GI problems, feeling cold and clammy, numbness around mouth, severe headaches (most likely due to head injury/nose injury  and not having the meds in my system), too weak/no energy to even get out of bed, it is getting better but have a hard time even sitting upright. The weakness and lack of energy is hard to describe. I don't feel like I am getting over a cold or a stomach virus. I feel disconnected from my body somehow, somewhat numb, shaky.

I did not discontinue my klonopin, dexedrine, provigil, just the two ACs and the Seroquel. I am posting this on the AC board because I feel like my suffering is tied to stopping the two ACs. After three days pdoc said I could take 100mg of Lamictal and later that day 100mg of Seorquel for sleep. I have begin to feel better since I have been taking the Lamictal but I am still not well. My pdoc says she assumes but is not sure my reaction is due to withdrawal from the meds (?). I have no clue what is going on. I am tired of feeling sick. Friday I felt better only to suffer all day Saturday. I am eating and drinking, so no dehydration or lack of energy from lack of nutrients.

Any ideas? Anyone?

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I missed 2-3 days of my meds because I just forgot to take them, one is Lamictal, and I had the exact same problem.  I thought I had a stomach flu or something.  I could not keep any food or drink down so I was dehydrated.  It was terrible.  As soon as I got my meds back into me, I felt better.  Hmmmm.

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My pdoc says she assumes but is not sure my reaction is due to withdrawal from the meds (?). I have no clue what is going on. I am tired of feeling sick. Friday I felt better only to suffer all day Saturday. I am eating and drinking, so no dehydration or lack of energy from lack of nutrients.

Any ideas? Anyone?

<{POST_SNAPBACK}>

I think it was very foolish of your doc to stop your meds cold turkey.  You have suffered way more than necessary because of it.  Seems like a med could have been given to increase your bp.  Is she going to let you continue taking Lamictal and Seroquel?  Will something else be prescribed?  I had hypotension when I was on Imipramine (like 15 years and 100 lbs ago).  I had to stop taking it because I was nearly passing out every time I stood up from my desk at work.

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Erika, I'm sorry you're feeling so crummy.  I'm amazed she had you abruptly stop all three mood stabilizers.  Why didn't she try tapering down on the seroquel first, since that's when you started having problems, and leave the other meds in place? 

And of course she can't tell what's going on; your poor body is so confused.  Watch carefully for anything that seems like seizure activity.  Check out the pinned thread above (oops, I now see you already did) on why stopping anticonvulsants abruptly can be not only unpleasant but dangerous.  But you might be just fine but out of it for a week or two. 

And I'd think that it will take at least a few weeks for you to start feeling much better.  Even if you restart meds, chances are you'll be a little off for a while until things stabilize.  Have you talked with her about her plan?  It worries me that she doesn't seem to have one.

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dropping 2 ACs at once scares me.

i'm going to ramble now b/c i'm exausted.  i hope you can get thru the post.  er. or you can just read the following sentence and skip all my reasons why and babbling....

maybe you should up the klono during these few days just in case? (says penny the seizure paranoia girl)

comming off that many meds at once is bound to fuck with your body.  esp. on top of the fucked your body got from the meds in the first place. 

i have super low blood pressure and (honest) my doc reccomended using sea salt to raise my BP.  but this is just when rising so...

gah.  i'd hate to say it, but this may just be a hell to ride out.  but i'd ask about upping the klono temp b/c it is a strong AC and you don't want discontinuation seizures.

also, a while back (i'll skip the why story) but i suddenly stared having painfully cold hands and feet and numbness around my mouth.  i called my doctor in a panic.  he said "stop talking for a minute."  i did.  he said "you're hyperventelating.  it causes cold and pain in the extremities and numbness around the mouth."  he told me to up my klonopin for the week.  (this was after i was dx'd with lyme and i was freaking out, i'm all better now.)

so... er, i guess i have one reccomendation with two reasons. 

as for the GI stuff... egads i have no idea.  try ginger and maybe the stomach flu "BRAT" (bannanas, rice, apples, toast) diet for a few days?

i'm so sorry erika.

let me know if your doc thinks a temp klono bump is ok. 

and i'll try not to worry too much about you.

(but i'll worry anyway)

much love

penny

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Thanks all. It is hard to write everything at once or even remember for that matter. I really appreciate your replies and will try to relate a few more details for anyone who will listen to me whine.

What is weird is that I know and you know that stopping any psyhopharm meds is going to have an effect. What I really do not understand is when my pdoc says she assumes I feel bad because of withdrawal. Come on, really? No shit. I am not happy with pdoc's thinking right now. To me her thinking is scattered. I saw her on Thursday and she said, almost as an aside, maybe we should put you on something for your blood pressure. OK ... how about some blood work, possibly even taking my blood pressure ... there is an idea. I have had lowerish blood pressure but never consistently low blood pressure. I am also hypothyroid and have been anemic off and all for years. Seroquel can affect the thyroid. So I think maybe I am anemic or the thyroid is messed up again and that is why I am feeling bad or at least it may be complicating things.

Not hyperventelating ... not panicy at all. I have GAD, I have had panic attacks, know what it feels like. Upping the klonopin is a good idea Penny. I will ask her today. But I am losing faith in our, pdoc and mine, med discussions. I used to feel confident in my opinions being taken into consideration, being listened to, I don't feel this anymore. Seizures scare me, as they should, I have no idea if I could be having any kind of seizures.

At first she agreed that the Seroquel was responsible for the fainting. Even mentioned another patient who had fainted because of the Seroquel. But now, she is convinced it is not just the Seroquel. Pdoc is now convinced that it is not just the Seroquel but the additive effect of the Lamictal, Trilpetal, and Seroquel that has caused the change. I am stubborn and repeated, repeated, repeated, NO. I only have had problems with the fainting since the Seroquel. Again, no she says it is the combined effect that I could handle the 2 ACs together but adding the AP did not cause the orthostatic hypotension it just was adding the Seroquel that made it come alive, so to speak. Her response was to start to lower my Lamictal and Trileptal doses both to help with the orthostatic hypotension and to eventually remove both meds from my cocktail.

A plan? Her plan: Is to get me to take Seroquel, just Seroquel. She is convinced that it can treat the BP better than anything. She hays she has seen great results in some of her patients. I first had the problem with Seroquel when I reached 200mg. We lowered my dose and started titrating up much slower. But over 200mg seems to be the problem. Pdoc talks to drug rep - no comment on my opinion of drug reps here - and tells me again about how normal titration is very quick, so the suggestion is I just titrate up more quickly. So over just a few days I am bumped up to 400mg. Deal with the side effects for a few days and move up again. But I have never seemed to adjust to the higher doses of Seroquel. The hypotensive side effect does not go away. And the rule of higher doses of Seroquel being less sedating than lower doses, well I am still heavily sedated from the Seroquel, sleep 12+ hours a night and need 400mg Provigil to even feel somewhat awake the next day.

I have taken Lamictal for at least two years now, Trileptal not quite as long. I have taken as much as 500mg Lamcital but my steady dose was 400mg. I never had any problems with the Lamictal other than some headaches with dosage increases.

Since Thursday I have been taking 100mg Lamictal and 100mg Seroquel. I have no problem with hypotension with the 100mg Seroquel. I can get out of bed at night with no problems. Pdoc's solution to the hpotension effects is that if I have to get up at night I should crawl. Granted, I do not want to hit my head again. OK, I'll crawl it will keep me safe but I also it is a bit ridiculous to have to resort to crawling if I need to get up at night. The crawling won;t be forever she says ... I have put up with a lot of side effects over the last 20+ years of psych meds but I am having a hard time with this.

I see pdoc this evening. I do not know what she will say. I don't know what to say. I am out of ideas. Nars, I agree it will probably take me a while to feel better but it is so hard to not to be able to even get out of bed every other day. I usually can only stay in bed all day if I am really sick, say from a bad stomach virus, but I am "sick" enough with whatever is going on in my body that I stay in bed. I hate it.

I have rambled enough. Penny, or any Mod, feel free to move this thread to another board. I am not sure where my rant, whining, and description of what is going on belongs. Just glad to be able to vent.

Erika

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She talks to the drug rep for medication recommendations?  She wants you to crawl to the bathroom?  She knows the Seroquel triggered all these problems and still won't take you off it?  It's time to jump ship.  Do you have access to any other pdocs?  I think it's time to start looking for another appointment.  Of course a good pdoc whose earliest opening is several weeks away is better than an iffy one who can see you next week, but either way it's time.

Before you go in ask whoever makes the appointment how many adult outpatient BP patients the pdoc is seeing; you don't want to deal with someone who deals mostly with hospitalized patients in crisis.  My old pdoc dealt mostly with inpatient care and detox; he was conservative (good) but stuck in his ways and bossy (bad).  YOu also don't want someone who deals mostly with juvenile treatment.

When you go in, tell the new pdoc about your treatment history; make sure he understands the medication craziness was caused not by you fooling around with your meds, but by your pdoc's treatment.  Don't dis the old pdoc; you don't want to get stigmatized as a difficult patient.  Tell him you want a new approach and are willing to work with him if he listens to you.  And be sure he does a complete intake, getting not only your med history but your original pre-medication symptoms.

This all sucks, and I hope things get better sooner rather than later.

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  • 2 years later...

I fainted this morning and hit my head on a door. I haven't fainted since 3rd grade. I'm only taking 25mg of Seroquel. I'm going back down to 12.5 then try to get off of it for good

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I fainted this morning and hit my head on a door. I haven't fainted since 3rd grade. I'm only taking 25mg of Seroquel. I'm going back down to 12.5 then try to get off of it for good

Did you talk to your doctor about this? Seroquel can cause low blood pressure. This may be what is happening or it could be something else entirely.

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Sounds like a doctor owned by the high priced, hi profile, hi profit margin Big Pharma that produces Seroquel............Its been recommended to me by other BPers, but when I check the price? I'm getting a similar result from the drugs I'm already taking.......and despite dizzy spells, I'm not crawling anywhere...

This doc sounds like a whore for big pharma, my advice? Run like hell, the opposite way and get someone concerned for your health, not for kickbacks ......... ;)

Hope you find a better doc, and soon

Stay well

cheers

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