Resistance to Drugs

I become resistant to any mood stabilising medication that I take daily

Here’s the typical scenario. I start a new medication, one that says it takes 1-2 weeks to take effect. I start getting a noticeable response to the drugs within hours – sometimes in less than one hour. So that’s good.

But then the drug stops working. Continue reading Resistance to Drugs

Drugs, Quality of Life, and Dilemmas

I’m still kinda grumpy about not being able to take the Ketamine. Here’s why.

I’m not disagreeing with my doctors – their points on why they aren’t keen on my taking it are very good. Ketamine apparently can push up blood pressure and is associated with tacychardia (rapid heart rate). And long term heavy use is associated with bladder infections and damage and possibly liver damage. And it may be addictive.

It should be noted though, that since Ketamine is used primarily as an anesthetic, most people would never be exposed to it more than once or twice in their life. The only long term users are those taking it recreationally. So there’s not really a heck of a lot of information on how toxic it might be if taken as a prescribed drug.

I will grant that not knowing the long term effects of a drug is a pretty darned good reason for a doctor to not want to suggest or recommend it it.

So much for why I shouldn’t take it. Here’s why I should. Ketamine stops my depression in its tracks and my quality of life goes up dramatically. Continue reading Drugs, Quality of Life, and Dilemmas

Ketamine currently Good, but Useless.

So. The Ketamine works very well as an antidepressant for me so far. But my doctors and psychiatrists are unwilling prescribe it to me because it has not been approved for depression, and in fact its ability as an antidepressant is so far from its approved use as an anesthetic that they are not even keen to take a chance and prescribe it as an ‘off label’ drug.

I understand their position and I really have no wish to possibly get them in trouble. But with no doctor’s prescription, I’m stuck.

This is not going as swimmingly as I would like. Not quite sure what my next step will be yet.

Ketamine is Complicated

Here’s an update about Ketamine.

The good news is that the Ketamine works brilliantly to pull me out of depression – it happens within about an hour if I take the Ketamine in injectable form. The bad news is that my doctor (general practitioner / GP, not psychiatrist) believes that the Ketamine dose I took is causing high blood pressure.

Actually, it’s worse than even that. We both are worried that the Ketamine didn’t just raise my blood pressure, but it is keeping it in a possibly long term elevated state – even after the drug should have flushed from my body. There is a fear that each time I take the Ketamine again, my blood pressure will ratchet up to an even higher value. Obviously not a good thing. Continue reading Ketamine is Complicated

Depression and taking Ketamine

I tried Ketamine yesterday.

I had been in a depression episode that lasted through all of September, which is a very long episode for me. This is problematical, because while many of the antidepressants have some effect in preventing me from getting depressed, none work to actually get me out of depression.

So there I was, with my parents getting ever more worried about me. I really was doing nothing – staying at home and sitting in front of the computer reading and articles all day. That’s all I did. All day. Literally.

Well, I fed the dogs too, but they were also upset because for the entire month I took them out walking perhaps three times. They are used to going for walks twice a day.

The Ketamine was a sort of a desperation measure, Continue reading Depression and taking Ketamine

Taking Seroquel: Expect This

You are going to sleep a lot!

If you are planning to take Seroquel, expect that you are going to sleep an awful lot. So much so, that you should assume that you won’t be able to do anything for 5-7 days after you start taking it. No office work, no social activities, no house work. Not even little everyday tasks.

The only thing I did in the first five days is sleep, stagger groggily around the house, sleep more, feed the dogs, eat, and then take meds and go back to sleep. Really. For five days.

It started improving somewhat after the 5th day, but slowly. If you decide to take Seroquel, I recommend that you…

  1. Take vacation for at least 2 weeks,
  2. Tell people that you will not be able to attend any social activities for two weeks,
  3. Hand over all the tasks that you do at home to someone else. This includes tasks like taking out the garbage or doing dishes or cooking.
  4. Don’t expect to be able to drive.
  5. If you have responsibilities elsewhere, hand them over temporarily to someone else for 2-3 weeks.

You will not be able to supervise or take care of children or pets for at least a week, so make sure someone else is able to do so. I am not kidding. You’ll be that groggy.

Start with a low first dose and increase it slowly

I’d suggest that you discuss with your psychiatrist about starting with 100 mg Seroquel per day and slowly increasing in 50 mg steps every 2 days until you reach the desired dose. That way you have some time to get used to the Seroquel.

If you start off by taking a dose of 200 mg or more, there’s a good chance you’ll sleep for upwards of 20 hours the first night (I slept for 32 hours). Sleeping for so long is kinda scary and kinda traumatic and might cause you to stop taking the Seroquel.

If your desired dose is higher than 300 mg, slowly increasing your dose in steps extends the amount of time you’ll be out of commission for. Assume that for each additional 50 mg step past 300 mg, you’ll need 1-2 days extra vacation.

Seroquel increases my productivity

When I take Seroquel, it allows me to make decisions and make things happen. Seroquel doesn’t feel like an antidepressant, it feels more like something that helps increase my productivity, a focusing and doing aide, if you will.

Seroquel also noticeably makes me less fearful of people – so I’m more likely to call someone, answer my phone, send or reply to an e-mail, write a business letter, call a friend, or feel comfortable talking to people generally.

For me, Seroquel acts a lot like a more powerful version of Tegretol.

…but still makes me groggy

So, if I can communicate with people more and get more done, then this is great, right? Well, it’s not quite a free ride. Even after becoming accustomed to the Seroquel, I still felt groggy during the day. In fact I felt like falling asleep every time I sat down, though it didn’t interfere with the stuff I wanted to get done.

I have found that getting out of chairs can be an effort– it requires me to have two hands on the arm rests and to make a deliberate effort to stand up. I also tend to lean against things rather than just stand up.

and causes sugar cravings

One of the odd side effects of Seroquel is that I have to have sugar every one and a half to two hours – if I don’t get the sugar, I get wan, light headed, and groggyenough to pass out.

This means that when I wake up, I have a cup of sweet hot chocolate (2 heaping teaspoons of sugar), and then throughout the day I drink hot chocolate every two hours or so. Or have biscuits (Pepperidge Farm Brussels cookies, yum!). Or Coke. It’s a pretty high sugar intake daily and it seems to be necessary.

Oddly enough, coffee doesn’t seem to have a noticeable effect in stopping the grogginess. Nor does a regular meal like lunch, unless I have a Coke or juice with it.

and chapped lips

The other noticeable side effect has been if I don’t drink enough fluids, I get chapped lips and dry hands. Given that I drink so much hot chocolate, this hasn’t been a big deal, but I’d still recommend that you keep moisturising cream and a tube of lip balm close by because the chapped lips can be painful.

A dose of Seroquel makes me very sleepy

I take my dose of Seroquel XR (200 mg) on evenings around 6:00 – 6:30 pm. Once I  take it, the Seroquel causes me to fall asleep within 2-3 hours, so that I am usually in bed between 8:00 pm and 9:30 pm.

The time before I fall asleep is fairly variable and the effect has occurred within as little as 1 hour or extended as long as 4 1/2 hours.

Crucially, there is very little time between when I realise the Seroquel is going to knock me out and when it actually does – there’s about 15 minutes between when I start feeling groggy and when I fall asleep. The sleepiness is intense and it is extremely difficult to fight to stay awake.

and messes with my social life

What this means is that after I take Seroquel I can’t drive at all – I may fall asleep at the wheel. It also means that if I want to do any social activities after 6:00 pm, someone has to provide transport and I may very well fall asleep at a restaurant or in the cinema or at a cocktail party. Or I may stagger around groggily, looking very much as if I am drunk.

Since the time between when I take the Seroquel and when I fall asleep is so variable, I can’t accurately predict if I will be okay if I go out. After a few attempts at doing this, I found it easier to simply stay at home after taking the dose of Seroquel.

Yes, I could take the medications later than 6:00 pm. But how late? Suppose we say about 10:30 pm, so I can go out with friends for dinner.

…and screws up the next day if I take a late dose

With the Seroquel, I consistently sleep for about 9-10 hours every night. If I take the dose at 6:00 pm as I do now, and fall asleep at around 8:30 pm, then I will get up at about 5:30 – 6:00 am. After coping with the groggy morning, I am able to start the day about 8:00 am. Not too bad.

If I take the Seroquel dose at 10:30 pm and fall asleep immediately, I’ll wake up 7:30 – 8:00 am. Add in two hours of being somewhat groggy on awakening and I’m not ready to face the morning until about 9:30 – 10:00 am. That’s a little late to get the day started, and leaves me out of sorts and fairly unproductive for the rest of the day.

…really messes with my social life

Bottom line – If I go socialising with friends to even a moderate hour on evenings and take the Seroquel dose on returning home, I lose the following day. If I take the dose before going out with friends or while out with them, I may fall asleep while socialising.

After a while, I started suggesting to people that we meet for breakfast, or lunch, or a coffee at 4:00 pm.

I can’t exercise on mornings

It turns out that I also can’t exercise on mornings. The grogginess that bothers me on mornings affects my coordination and can leave me staggering about like a drunken man. It’s not a state conducive to exercise. The grogginess effect wears off during the day, so the best time to exercise is the 3-4 hours before I take my medications.

and travel requires careful planning

If you plan to travel, the grogginess and tendency to fall asleep matters. I had to travel and I had visions of falling asleep in the airport and missing my flight. Or having flight attendants being unable to wake me at the end of the flight. Or staggering up to an Immigration official as if I was drunk or drugged. The concern was sufficient that I stopped the Seroquel before starting to travel.

More prosaically, I wonder if people taking Seroquel who have subway or train or bus rides fall asleep and regularly miss their stops.

I suppose I could adjust the organisation of my day so that I can use my evenings more, but I am not sure how. With Seroquel, there seems to be a fixed amount of time that you spend asleep or groggy. For me that’s about 10-12 hours a day and that amount doesn’t seem to decrease with ongoing Seroquel use.  The only trade off seems to be between having more awake time on an evening vs. on a morning. Here’s my daily schedule

  • 6:00 am: Wake up.
  • 6:00 am – 8:00 am: Wander around the house groggily and out of focus.
  • 8:00 am – 6:00 pm: Do regular activities during the day
  • 6:00 pm – 6:30 pm: Take medication – Seroquel XR (200 mg).
  • 6.30 pm – 9:30 pm: Stay home and do stuff /  relax until I fall asleep.
  • 8:00 pm – 9:30 pm: Go to bed

Any time I go to sleep later, I get up later, and the regular activities of the day start later. It’s more like I am rotating the entire schedule rather than adjusting or fine tuning it. That rotation may work better for some of you, but I like the relatively early start of the day.

In Summary

Once, I get past the initial sleepiness, Seroquel does work as a mood stabiliser – it makes me more able to focus, and more able to get things done, and it allows me to interact with people more easily.  I get more done and I keep in contact with the people I need to.

However, balanced against the productivity is the sleepiness / grogginess that never went away and which remains an intrusive element in my life. I gain productivity, but I also lose half the day to sleep. If I am currently unproductive, that’s not a bad trade off, but in the long run, the sleepiness / grogginess seems to intrude too much into my life.

If you want additional information on Seroquel, check out the Crazy Meds website.

Note: I have found that if I take any medication on an ongoing basis, I develop a resistance to it, and it stops working. It was for this reason that I stopped taking Seroquel.

You might feel cold when coming off Seroquel

For about six days after I stopped taking Seroquel, I complained a lot about feeling cold. A lot. Didn’t matter where I was.

It’s hard to tell what causes each symptom you notice, and after coming off the Seroquel, I’d been getting very little sleep. But the complaints of being cold…

  1. Only started after I came of the Seroquel, and
  2. I’ve handled sleepless nights before with fairly mild aftereffects, and
  3. The temperature here had been 24-30 degrees Celsius (75-85 F).

I’ve put feeling cold as a possible side effect of coming off Seroquel. Any feedback in the comments would be appreciated.

Tegretol: Effects and Side Effects

Tegretol pulls me down from mania quickly

I tried taking Tegretol (carbamazepine) as an antimanic and as a mood stabiliser. Because of my general resistance to drugs I do not take it daily. However, if I am feeling manic enough that I do not think I can manage using just behaviour adjustments, I take Tegretol, and it calms me down within 20 minutes.

The way this plays out is that I’d know I’m manic, but as long as only the minor signs are showing, and I’m not being irritable, or trying to buy new stuff, or having too many ideas flickering through my brain, I just using calming techniques. However, if I start getting annoyed at people or situations, or shouting at people, or if the rush of ideas is preventing me from actually getting things done, I’d take a 200 mg Tegretol dose and excuse myself and sit quietly somewhere for 20 minutes. It’s kinda like taking aspirin for a headache.

When taken in this manner, nothing happens for the first ten or so minutes. The I can feel the Tegretol as it starts to calm the frenetic impulses and anxiety, makes me less twitchy, and settles my thoughts. And twenty minutes or so later, I’m good.

My thoughts calm. I don’t feel to quarrel any more.

I no longer have the urge to shout or scream at people, I usually don’t fuss any more about whatever triggered the argument, my coordination improves, and I can focus on tasks and get them done, and I can focus on studying or other tasks requiring ongoing concentration.

I also occasionally take Tegretol about half hour before I start something stressful, such as giving a presentation or entering into a situation that is likely to be argumentative. And I take also occasionally take it before doing something that requires manual dexterity, such as servicing my bicycle.

My psych says Tegretol should not take effect as quickly as twenty minutes, but I have checked it over many occasions and the effect is very consistent. Your experiences may be somewhat different from mine though.

When I first start taking Tegretol it makes me sleepy. In fact it used to make me so sleepy that I had to restart drinking coffee just to get through a morning at work without falling asleep. But this effect fades in one to two weeks on the medication.

The most curious aspect of Tegretol is that when it first takes effect Continue reading Tegretol: Effects and Side Effects