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Author Topic: Saw psychiatrist for first time, came back with all sorts of meds  (Read 1560 times)

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Offline kutekat

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So, I just had an appointment with a psychiatrist for the first time ever today. She was a very lovely woman, very smart professional and confident in her work. She took notes for at least an hour and we discussed many of my problems. She's putting me on prozac 10mg, klonopin .5mg 2x a day, and seroquel 25mg at night for sleep. i was VERY scared about being put on seroquel, an antipsychotic, but she assured me that it is such a low dose and nothing will happen. she said to take it every night, but i asked if i could take it as needed and she said that's fine. she also assured me that with the klonopin i will have no "addiction" issues as long as i am under her care, which reassured me a lot. she brought up me being bipolar though...because of how i have reacted to SSRIs in the past. so that concerned me because i really don't think i am, but i don't know. is anyone else on a similar regimen? has anyone taken seroquel as needed or on a daily basis for sleep? would you guys recommend taking it every night? the pill bottle says i could even take it twice a day for anxiety/panic as needed. so confused about that. i never thought i would need an antipsychotic? overall, the experience was good and she was very knowledgeable and professional. i will be seeing her in a week and she also wants me to get some lab work done. i hope this will be the answer for all my problems, or at least give me my life back mostly.

if you want to add anything please feel free to do so. i will be keeping everyone updated on how things work out.
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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #1 on: December 10, 2013, 10:10:23 PM »
has anyone taken seroquel as needed or on a daily basis for sleep? would you guys recommend taking it every night?

Seroquel is fairly sedating and thus sometimes prescribed for insomnia. Given the possibility of you being bipolar to some degree it may be a better bet than another sedating drug such as trazodone.

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the pill bottle says i could even take it twice a day for anxiety/panic as needed.

Yes, Seroquel has anti anxiety properties and is sometimes prescribe to supplement antidepressants which are not 100% effective, and occasionally even as the primary anxiety med when antidepressants haven't worked.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Online Abraham2007

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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #2 on: December 10, 2013, 11:03:10 PM »
Based on your pasts posts, your symptoms are usually agoraphobia and panic attacks.  Likewise I believe you have chronic fatigue syndrome, where your brain tires easily by mid-day, which is common among the anxious.  Due to these symptoms - I don't think you're bipolar - where you get manic highs or suffer schizophrenia.  You have Panic Disorder.

I'd be interested in how the lab reports help the psychiatrist.  If you don't mind, could you discuss if these reports require blood work?

I'm glad you found a psychiatrist.   You sound more hopeful and excited about the days to come.  Prozac is widely used in the treatment of Panic Disorder.  Although you are starting at 10mg, you may need to anticipate going much higher.   With a good antidepressant in use, 2014 should be a good year for you.   :happy0151:
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Offline kutekat

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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #3 on: December 10, 2013, 11:19:13 PM »
has anyone taken seroquel as needed or on a daily basis for sleep? would you guys recommend taking it every night?

Seroquel is fairly sedating and thus sometimes prescribed for insomnia. Given the possibility of you being bipolar to some degree it may be a better bet than another sedating drug such as trazodone.

Quote
the pill bottle says i could even take it twice a day for anxiety/panic as needed.

Yes, Seroquel has anti anxiety properties and is sometimes prescribe to supplement antidepressants which are not 100% effective, and occasionally even as the primary anxiety med when antidepressants haven't worked.

Ian

really? i did not know it could be used as an addon for an antidepressant to work better! would it still have benefits the next day if i only take it at night? she also told me about people using it for anxiety, she pulled out a big book and showed me the uses...one of them was "severe treatment resistant anxiety" i don't think i've reached that point though  ::)





Based on your pasts posts, your symptoms are usually agoraphobia and panic attacks.  Likewise I believe you have chronic fatigue syndrome, where your brain tires easily by mid-day, which is common among the anxious.  Due to these symptoms - I don't think you're bipolar - where you get manic highs or suffer schizophrenia.  You have Panic Disorder.

I'd be interested in how the lab reports help the psychiatrist.  If you don't mind, could you discuss if these reports require blood work?

I'm glad you found a psychiatrist.   You sound more hopeful and excited about the days to come.  Prozac is widely used in the treatment of Panic Disorder.  Although you are starting at 10mg, you may need to anticipate going much higher.   With a good antidepressant in use, 2014 should be a good year for you.   :happy0151:

i also don't think i have bipolar, i have never had a manic episode or even hypomanic. and i also agree with the chronic fatigue syndrome....i told her about how i have absolutely no energy and i'm thinking that's why she wants to try prozac since it amps people up supposedly. well i am going to the lab tomorrow, and i think it will require blood work. she said she wanted to check my thyroid, b vitamin levels, and my vitamin d levels. also she wants to screen me for any drugs.  :fragend005: whatever. and thank you so much for the kind words, i am pretty hopeful and excited, but still nervous. i think the klonopin will help get me on track much faster and be able to tolerate any unpleasant side effects the prozac might produce. but 2 people in my family have had success with prozac, so hopefully it works for me too!
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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #4 on: December 11, 2013, 01:00:48 AM »
i did not know it could be used as an addon for an antidepressant to work better! would it still have benefits the next day if i only take it at night?

Yes, at least in the morning. Quetiapine the active ingredient has a short half-life of only about 6-7 hours, but the active metabolite adds another 8-10 hours of activity.

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one of them was "severe treatment resistant anxiety"

Yes, which is what I was alluding to at the end of my last post. But it should be a last roll of the dice option as it has some potential very unpleasant side-effects at high doses.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline kutekat

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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #5 on: December 11, 2013, 04:15:22 AM »
i did not know it could be used as an addon for an antidepressant to work better! would it still have benefits the next day if i only take it at night?

Yes, at least in the morning. Quetiapine the active ingredient has a short half-life of only about 6-7 hours, but the active metabolite adds another 8-10 hours of activity.

Quote
one of them was "severe treatment resistant anxiety"

Yes, which is what I was alluding to at the end of my last post. But it should be a last roll of the dice option as it has some potential very unpleasant side-effects at high doses.

Ian


i think i will try the seroquel tomorrow night along with my other new regimens. i can't say it doesn't scare me though. also, with the klonopin, twice a day should mean what exactly? take one in the morning and then 12 hours later? i forgot to ask her about that.
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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #6 on: December 11, 2013, 07:05:47 AM »
with the klonopin, twice a day should mean what exactly? take one in the morning and then 12 hours later? i forgot to ask her about that.

Yes, about that. You don't need to time it to the minute though as Klonopin has a long half-life, up to 50 hours. In fact many wouldn't notice a difference with once a day dosing.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline kutekat

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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #7 on: December 12, 2013, 03:46:57 PM »
with the klonopin, twice a day should mean what exactly? take one in the morning and then 12 hours later? i forgot to ask her about that.

Yes, about that. You don't need to time it to the minute though as Klonopin has a long half-life, up to 50 hours. In fact many wouldn't notice a difference with once a day dosing.

Ian


Well, i usually take one first thing in the morning along with my prozac, and i can feel it wear off around 8-9 hours later. should i just take it in the AM and then one later at night when i feel like it?
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Offline kutekat

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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #8 on: December 12, 2013, 03:51:32 PM »
also just an update for my little psych journey. i just got back from the lab to get blood work done. i asked what they were testing me for and they said thyroid, b vitamin, vitamin d, and then the woman said "all your organs, kind of just everything" hmmm....whatever. and they also drug tested me  :-X i didn't ask for what but the lab papers said something along the lines of oxycodone...and 5 test something?? i hope she does this with all her other patients because i told her i don't do drugs! i don't drink alcohol and i haven't smoked marijuana in 1 1/2 years. and, so far this is day 2 of prozac 10mg and klonopin twice a day. feeling ok. still haven't taken the seroquel....because  i am really scared. think i will take half a tablet tonight, or just the whole pill. i hate feeling extremely sedated and i really hope it's not like that :/ and i really don't want to have to take this every day for too long!
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Online Abraham2007

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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #9 on: December 12, 2013, 05:04:53 PM »
I'm curious if Ian advises you to take the Klonopin once in the morning, at the same dosage of taking two 1/2 pills twice in a day.  At least, that is what I would do, since you can take the Seroquel at night, and you probably do most of your activity during the day, and less so at night.  So one full tablet of Klonopin in the morning to get you through one whole day would be more advisable.

Sounds like your psych doctor is performing a physical.  For me, those are usually done by my general practitioner, who can relay that information to the psychiatrist. Don't worry about the marijuana.  It should have been out of your body by now.  Not to mention, it's not uncommon these days.

Some psych doctors are now taking blood in order to better decide what medication to give a client.  I'm not sure if these tests are accurate, but I was curious if your psych doctor was one of those doctors, however it seems she just asked for a regular physical.

In a week, I'm sure you'll be feeling better with the Prozac more in your system, since it's only been about two days. :happy0151:
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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #10 on: December 12, 2013, 06:10:43 PM »
Well, i usually take one first thing in the morning along with my prozac, and i can feel it wear off around 8-9 hours later.

I don't know what you're feeling, but Klonopin is a slow starter taking 3-4 hours for plasma levels to peak, so I don't think the feeling is because Klonopin levels have dropped below therapeutic levels. Plus, with daily dosing the amount of the drug in your system accumulates to around 3 times the peak from a single dose and pretty much remains constant after that.

Is there something else going on around 8-9 hours after you've taken the AM dose?

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should i just take it in the AM and then one later at night when i feel like it?

If it works for you, sure.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline kutekat

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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #11 on: December 12, 2013, 11:32:02 PM »
Well, i usually take one first thing in the morning along with my prozac, and i can feel it wear off around 8-9 hours later.

I don't know what you're feeling, but Klonopin is a slow starter taking 3-4 hours for plasma levels to peak, so I don't think the feeling is because Klonopin levels have dropped below therapeutic levels. Plus, with daily dosing the amount of the drug in your system accumulates to around 3 times the peak from a single dose and pretty much remains constant after that.

Is there something else going on around 8-9 hours after you've taken the AM dose?

Quote
should i just take it in the AM and then one later at night when i feel like it?

If it works for you, sure.

Ian

no, there's absolutely nothing that happens around that time! i just start to feel more tense again. i'll bring this up to her and see what she thinks, or maybe just play around with the PM dose myself.


also another little update: i know it's very early to say this, but i have had more energy than i've had before (which was nonexistent) i think the celexa was making me extremely tired. or maybe the prozac is making me a little uppity, i don't know. but i have hope that this will work.
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Offline AncientMelody

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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #12 on: December 13, 2013, 11:27:12 AM »
I would try not to take the drug testing personally. Drug use CAN cause psychiatric symptoms so it may just be her practice standard.  Low Vitamin B, D can cause low energy issues, thyroid can cause particular anxiety symptoms. Seroquel can affect cholesterol, blood glucose, so generally checking those at baseline before treatment is common.
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Offline kutekat

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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #13 on: December 15, 2013, 09:48:07 PM »
I would try not to take the drug testing personally. Drug use CAN cause psychiatric symptoms so it may just be her practice standard.  Low Vitamin B, D can cause low energy issues, thyroid can cause particular anxiety symptoms. Seroquel can affect cholesterol, blood glucose, so generally checking those at baseline before treatment is common.

i suppose you're right. it'd be nice to know how things are in my body anyway.


and, as promised another prozac update. only day 4 (usually when my side effects begin on ADs and i've had an interesting side effect. last night i went to bed early and i had a very vivid, realistic and terrifying dream. at first i dreamt in my dream that i was in a dark scary room, and i just remember i felt so scared. then i woke up from that dream IN the dream and i remember i was so scared. i was shaking in my dream and i remember calling for help and calling for my mom, then i remember reaching for a klonopin and then i went into the living room to tell my mom how scared i was. then i FINALLY woke up and i was so confused if i was sstill dreaming or not, i felt really alarmed and scared but that went away fast. it was odd to say the least...hopefully i don't have another. i've bought some doxylamine to help me sleep better tonight, since diphenhydramine makes me feel a little uncomfortable. if it doesn't work well and i have another one of those nightmares then i am going to bite the bullet and take the seroquel. i even asked the pharmacist her advice and she said i should just take the seroquel since it'll work better, i'm just afraid of how sedated it will make me feel. i remember when i had food poisoning they gave me a shot of promethazine and they told me to take a promethazine pill every 4-6 hours (don't remember) until i ran out. i slept for basically 3 days. i've never been so sedated, and when i finally realized i need to STOP taking this i still felt extremely sedated and dreamy and had really bad blurry vision. i really need to stop being paranoid i guess. other than that, i feel fine.
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Online Abraham2007

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Re: Saw psychiatrist for first time, came back with all sorts of meds
« Reply #14 on: December 15, 2013, 10:29:42 PM »
I've never dreamt about an antidepressant or a benzodiazepine in the story line, however years ago, I dreamt a previous therapist and I were in a 60's style convertible, with the top down, as we flew high in the sky over my old neighborhood, even worse, my therapist was the driver as I sat in the passenger seat.  Fortunately I woke up from that dream *shudders* :laugh3:

Good you're feeling fine on the Prozac, and it's not even been quite a week yet.  :P
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