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#1 Endlessnight

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Posted 19 March 2010 - 05:39 PM

Hi.
I'm sorry this is such a long post but I really want to hear what thoughts or suggestions anyone might have for me so i've tried to explain everything.
I I've tried different anti-depressants over the past seven or eight months since I went to a psychiatrist and although they have helped my depression the side effects are driving me crazy:  fuzzy headed, confused, feeling like my brain isn't connected right, dry mouth, hoarseness, weight gain, sugar craving, etc etc.
I take 20mg of Flozak every morning and have no problems with that really, but it's the anti depressant meds that I have been taking at bedtime that I have had my main problems with. I have taken many different meds but most recently was taking something called Ludiomil, then the doc changed me to Amitriptyline 25mg.  I gained so much weight and had such a bad craving for sweets while taking both of those meds that my self esteem has been at an all time low.  I felt I had no self control or will power and was so frustrated at myself that I considered not taking any meds any more.  
I have been back to the doc so many times and since depression meds here are limited he told me there wasn't anything else he could prescribe for me.  
Though I know that messing with your medication isn't a good idea I decided I needed to feel that I was in control of my meds and not that it was in control of me.
For the past week I have been taking one half of a 50mg Truxal at night along with one half of Lexotanil pill (the doc told me to take a small dose of Lexotanil whenever I feel expecially stressed or down, at my own discretion).  The Lexotanil relaxes me so it offsets to some extent the effect of the Truxal which I had tried before and had to stop taking because and it made me so hyper that I couldn't sleep at night.  So far things are okay, I have the dry mouth back a little but I have yet to take the Truxal without the Lexotanil so I still don't know how it will affect my sleeping.  Tonight will be my first night taking only the Truxal.  I hope I can sleep and that I have found a solution to my med problems.  If not, then i'll be back at square one and I really don't know what to do if that happens.

Please tell me your thoughts and any suggestions you might have for me on this subject.
Thank you.

Edited by Endlessnight, 20 March 2010 - 01:42 PM.
Embarassed at the last part of my post plus what I was trying to say was not clear


#2 David O

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Posted 20 March 2010 - 02:28 PM

Good morning Endless,

This is quite a cocktail you're taking:


  • Truxal-- low potency anti-psychotic with commn side effects of Lethargy / sleepiness, low blood pressure, dry mouth, blurred vision,  constipation, weight gain, difficulty urinating or stiffness. (I wonder why this was used alone since it's not generally very effective by itself)
  • Flozak- ???? sure this isn't Flomax for urination problems
  • Amitriptyline for depression or insomnia, PTSD, migraines, pain
  • Lexotani-l- anti-anxiety which can impair memory and working memory
I'm not sure I got them all, but this is a complex cocktail-- and one I wouldn't play with, especially the Lexotonil and Truxa. I would strongly encourage you to talk to your physician or a pharmacist. By the way, where are you (country) as these are not commonly prescribed in the US (the center of the universe:eek:) except for the amitryptiline.

Good luck Endless and I hope this helps,
David

Edited by David O, 04 April 2010 - 10:08 PM.


                              

#3 Luna-

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Posted 21 March 2010 - 11:28 AM

All hail, well met, EndlessNight and David!
Pleased to meet you, Endlessnight. : )
(Don’t worry I haven't lost it; I just came home from a 27hr shift taking bloods; and I'm rather bug-eyed and waiting for the coffee to wear off so I can fall asleep :))

I'm not a psychiatrist but I have a strong interest in medications, since I've been on so many, and also because... well... I am an information junkie. :) (Gotta know!)

I did a bit of detective work and found out that Fluzak is the name for fluoxetine (Prozak) in Oman. Is that where you live, Endlessnight or are you in Saudi Arabia?

Truxal is chlorpenthixene, one of the typical anti-psychotics, but at a lower dose it has anti-depressant (AD) properties so it is sometimes used as an adjunct to an AD. So that may have been the reasoning. It is also known to be sedating. Of course there’s always those of us who aren’t like the rest and get different side-effects! As far as I can gather you’re not taking this anymore?

Amitryptiline is one of the oldest anti-depressants but it's evergreen, it's a triple re-uptake inhibitor and as such, is still extensively used. (A bit like old lithium remains the gold standard for bipolar, despite all the newer meds.) I was on 225mg ami while I was breast-feeding as it's the safest AD known not to harm the baby (that was a major dose and even at that dose it didn't help much. I had a dreadful post-natal depression and was adamant that J. was going to have 6 months of exclusive breastfeeding, come hell or high water. I took a lot of flack from my ex and the pdoc for that!) But I digress. 225mg was fattening and gave me desert-mouth.

(A good tip for the dry mouth was one I got from a pdoc: obviously drink more water, but add a very small amount of lemon juice to the water, it stimulates the salivary glands and helps alleviate the dry mouth more than plain water.)

I did clinical trials/research work in an academic pharmacy department for 7 years and learnt that pharmacists know more about drugs and potential interactions when you take a cocktail, than doctors. So I get that kind of information from the pharmacist. There are med interaction checkers online too, which can be useful for getting questions you can ask your pdoc. Just don’t get too spun in on those, as they err on the side of caution. General prescribing guidelines are also the conservative side as the pharm companies protect themselves; experienced pdocs learn where they can safely push the envelope.

Ludiomil is a tetracyclic AD; I seem to gather than you're not on that anymore?

As David says, Lexotanil is habit-forming. It's bromazepam, a benzodiazepine, used for anxiety as David says, but also for insomnia. The problem with benzo's is that you develop tolerance and need stronger doses to get the same effect – which is the fast track to addiction. So best not to take that regularly, but only intermittently for those severe insomnia nights and never take more than prescribed. (I take midazolam, sparingly, usually the night after a particularly bad night, so I can get back on a more even keel.) As far as I can tell from your post, your pdoc gives you your own discretion and you don’t take this regularly anyway.

I totally agree with David with his caution about playing with the meds on your own. Rather get with the pdoc and ask him about doses you can adjust according to what is happening, so he remains happy. As you can imagine, if you don’t take it the way he said, it’s hard for him to evaluate how it’s working. A pissed-off pdoc gets testy with us and is less inclined to be kind and to trust us. Sometimes pdocs won’t listen to us when we describe how we feel, or they don’t believe us(!) Sometimes you need to change to one you feel more comfortable with. That is, if you have the luxury. We don’t have enough pdocs in South Africa and none in the town where I live, so our choices are limited.

Urine leakage: I can't say if any of the drugs might be causing this, you'd have to ask your pdoc. If you want to try and google this for more info, the medical term is 'incontinence'. But if I remember right you're about the same age as me (are you? I'm 48) and I get this when I cough or sneeze (in which case it's called 'stress incontinence'.) Yes, it's embarrassing :o and therefore not talked about much (and I can't say I raise the topic with anyone irl either!) It can happen as we get older. They don't say "growing old is not for sissies" for nothing...! :( It can be counter-acted with Kegel exercises (google that) and in severe cases with medication. This cause is one of the possibilities.

-----
Sorry that got so long - psych meds are a subject dear to my heart and perhaps someone else can use this info. I read up a lot when I’m put on a new one, so that I’m forewarned. These substances are powerful, especially when you start mixing. The pdoc does know about interactions, he’s not just mixing at random. And each has his  own preferences.

Edit: Sorry, I see you are still taking Truxal. And yes, side-effects drive you crazy. It's a risk versus benefit scenario.

Edited by Luna-, 21 March 2010 - 11:31 AM.

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#4 Endlessnight

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Posted 21 March 2010 - 04:11 PM

Hello David and Luna.  Thank you for replying to my post and thank you for teling me more about the meds I have been and am taking.  My knowledge of such is very limited.
I live in Saudi Arabia, as Luna guessed and depression meds here are limited.  To even see a psychiatrist I had to register with a government office, and to get the meds the doc prescribed me I had to register my ID no with the pharmacy.
I first went to a psychiatrist one year ago.  This is what he prescribed me at first:  Salipax and Lexotanil.  After about a month or so I started cutting down on the Lexotanil and started taking Endep at night with Salipax in the morning.  I had a lot of problems with the Endep though so after taking it for over a month I went back to the doc and he changed me to Truxal which as I said caused insomnia.  So I went back to the doc and he put me on Ludiomil in the evening and Flozak in the morning (the Salipax was expensive so I asked the doc to give me a cheaper alternative and he prescribed Flozak).  Again I had problems with the Ludiomil so the doc put me on Amitriptyline.  I finished the bottle a few days ago and started taking the Truxal again as I explained in my first post here.
I think I will have to go back to taking the Endep as i'm having problems sleeping again so the Truxal doesn't seem to be working.  I didn't know it was addictive by the way, the doc told me the Lexotanil was but he didn't mention that the Truxal was too.  I don't want to be mixing up my meds like this but i'm so tired of going to doctors, besides which it's expensive and I can't afford to keep going back, not just to the psychiatrist but to the other docs I'm supposed to see.  I am taking medication for high cholesterol, bp, menopause as well as the depression meds.
Luna: thank you for the dry mouth tip, I will surely give it a trry.
Please feel free to comment on this latest post now I have written down my past and present med history more extensively.
M.

#5 Luna-

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Posted 22 March 2010 - 05:08 AM

Flozac and Salipax are both fluoxetine.
Endep is another name for amitriptyline.

If you don't mind me asking, what problems did you have with Ludiomil (maprotiline) and the Endep?

Sometimes pdocs give us no information about possible side-effects. Mine is particularly poor at this, maybe that's why I compensate with research.

Wikipedia, although not seen as a reliable source of information by many people, often has comprehensive medication information. Someone took the time to write a lot of entries there. So you may be able to look up info there, when you have internet access.

Best of luck. I have been on the med go-around trying one after the other after the other.
Don't tell me the moon is shining; show me the glint of light on broken glass. - Anton Chekhov

#6 Guest_ASchwartz_*

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Posted 22 March 2010 - 03:54 PM

Hi Luna and everyone:

Always ask your psychiatrist and medical doctor about side effects or possible side effects from any medication they put you on, including over the counter meds,

(That way you can't confuse birth control pills with valium...:):D )


Allan

#7 Endlessnight

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Posted 22 March 2010 - 04:46 PM

Hi Luna.  The problems I had with the Ludiomil and the Endep were very dry mouth, sore throat, hoarseness, sugar craving, weight gain.  I have decided I shouldn't take the Truxal any more.  I love the energy it gives me during the day but at night my brain won't shut down to let me sleep, plus reading David's post has made me realise it is dangerous to play with drugs that are addictive.  My only solution is to go back on the Endep.  As I said, my med choices are limited.
M.

#8 Endlessnight

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Posted 22 March 2010 - 04:53 PM

Thank you again.  I had absolutely no information or idea about the meds I was taking.  What you have written and explained to me will help me a lot.  Take care,
M.

#9 Luna-

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Posted 23 March 2010 - 01:33 AM

David,

Are you sure Truxal is habit forming? It's a typical anti-psychotic and none of the other typicals (or atypicals for that matter) are habit-forming. This is why they are used for longer-term treatment of anxiety and insomnia, where using a benzodiazepine regularly in the long-term can all too easily lead to addiction.

I can't find anything that says chlorpenthixene is habit-forming. :confused:

It's not that I want to challenge you (really! :)) but can you tell me where you found that so I can understand why?
Don't tell me the moon is shining; show me the glint of light on broken glass. - Anton Chekhov

#10 David O

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Posted 23 March 2010 - 02:27 AM

Hi Luna,

Good thing you caught it... it's not habit forming, you're right, in fact it has no potential to be habit forming. I meant to say that long term use can result in tardive dyskinesia-- uncontrollable movement of the  trunk, legs, arms, fingers, mouth, lips, or tongue. Once symptom of  Tardive Dyskinesia appear, the antipsychotic/neuroleptic must be  discontinued. About 20 percent of people taking antipsychotics/neurleptics for more than a yea are affected-- some with nearly unnoticeable effects while others with more pronounced effects.

Endless, have you been prescribed anything like Reserpine, Artane, Trihexyor, Levodope or any other med to counter the potential for developing tardive dyskinesia? You may want to raise this issue on your next visit. On your own, vitamin E has been shown to be effective at times.

Sometimes my head gets ahead of my 2- finger pecking and I'll say the wrong thing.

Endless, my sincerest apology for giving incorrect info, I'll try and slow down on these more technical questions.

David

Edited by David O, 23 March 2010 - 02:35 AM.


                              

#11 Endlessnight

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Posted 23 March 2010 - 04:31 PM

No need to apologize.  I actually decided to stop taking the Tuxal because it gives me sleep problems.  I will miss the way it made me feel full of energy during the day though, but it's a choice, either I sleep well or I have energy.  I've suffered from insomnia since I was a teenager and since i've been taking the meds (except for the period of time I was taking Truxal which was only or a couple of weeks) I have been sleeping well.  I dont want to go back to tossing and turning all night.  No, the doc didn't put me on anything with the Truxal, but as I said, I only took it for a couple of weeks before I went back to the doc and told him of my sleeping problems so he switched me to the Ludiomil.  Would it be an alternative to take the Truxal in the morning instead of the Flozak and take something else at night to help me sleep?  What do you think?

#12 Luna-

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Posted 23 March 2010 - 05:55 PM

I don't think it's wise to mess with the Flozak or replace it with something else. Truxal is a different type of medicine from Flozak and Flozak needs to be taken continuously for it to work. In fact, I'd be nervous to make those kind of changes on my own. I read and research about my meds, but I don't know any neuroscience, so I really have no clue what is actually happening in my brain, especially not with all the interactions. :confused: (I'm on 4 psych meds and three other chronic meds - quite a cocktail coursing through my veins!:eek:) Managing the doses and mixes is really the domain of the pdoc.

My pdoc is okay with me shifting once-a-day meds from morning to evening or vice versa. He's also okay with me dividing doses if I want. As long as I take it all. :) Perhaps you could check with your pdoc what is okay with him for you to adjust?

I'm really hesitant to suggest anything that you can do; it's really not for me to say. You really should speak to your pdoc again.

Oh, and those problems you described with the Endep and Ludiomil - those are all common side-effects. As the Americans say, "it sucks". :)
Don't tell me the moon is shining; show me the glint of light on broken glass. - Anton Chekhov

#13 malign

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Posted 23 March 2010 - 06:02 PM

Too, only a couple of weeks on a medication that makes you hyper might not be enough for you to become accustomed to it.  If you tough it out, you might gradually be able to sleep better, and still have the brighter days.  It might still be worth trying.
When the way comes to an end, then change.
Having changed, you pass through. -- I Ching

#14 Endlessnight

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Posted 26 March 2010 - 01:31 PM

You are probably right, but after reading of it's side effects from long term use, plus my insomnia, made me decide to go back to Endep.  Tonight will be my third night taking 25mg along with 1/4 of Lexotanil.  Tonight will be my last night taking the Lexotanil, hopefully, and in a few days I will cut my dose of Endep down to half a tablet, since the Endep originally prescribed for me by my doc was 10mg but I couldn't find that lower dose so I took the larger dosage packet and, as I said, will gradually cut down.  Already I am having some dry mouth problems, which is making me cough a little, and I feel the chocolate craving coming back but i'm trying to resist.  I hope once I cut down the dosage I will be okay.  Keep your fingers crossed for me.  Thank you all for your suggestions and help.
M.
p.s.
For the past week or so I have noticed my breasts have been feeling swollen and I dont know why. I take HRT but i've been taking it for a couple of years now.   Can depression meds cause something like that?

Edited by Endlessnight, 26 March 2010 - 01:34 PM.
I forgot something


#15 Luna-

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Posted 26 March 2010 - 03:03 PM

Hi M, my fingers are crossed. :D

Endlessnight said:

For the past week or so I have noticed my breasts have been feeling swollen and I dont know why. I take HRT but i've been taking it for a couple of years now.   Can depression meds cause something like that?
Yes. :) So can HRT. Here's some info about Endep. Bear in mind that the list of side effects (SEs) must list everything that has been reported while people have taken it, whether due to the drug or not, so the list seems inordinately long and horrific, when in fact many of them are rare. I was 225mg and only had a few of them.
Don't tell me the moon is shining; show me the glint of light on broken glass. - Anton Chekhov

#16 PinkSunglasses

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Posted 28 March 2010 - 08:17 AM

Hi Endlessnight,

nice to meet you here :D
I am also taking three different medications, two are antidepressants. I was so positive about taking meds because I knew I needed and wanted them after years of not being sure what was wrong and doing therapy etc. (Now it is therapy and meds)

I am sure that I have hardly any side effects because I am so optimistic about it. It must play a role. Also my doctor is so nice (I met not so nice or smart or pleasant doctors before!) and he also works in the research department. So, I was able to read of two studies about the combination of 2 antidepressants and how much more people got well. It was a University of Ottawa and some New York university study. It gave all the numbers, all the details etc. Something like that makes one feel safer than only checking the internet but there is correct information out there.

I find the idea of speaking to the pharmacist very good. I would also not change any medication on my own. Also, please notice that medication needs usually a couple of weeks to show effects. And it also can change over time. So, switching or changing things within a short period of time will not give you the right information about how the medication works with you. Of course, if there are severe or very unpleasant side effects, one should stop right away and contact the doctor.
If you are feeling low or if you find it hard to talk to the doctor, why not make a list of questions and take the list with you to the visit? I had to do that in the beginning because I was quite nervous.

Did you try each one of the meds that you say are not so good for you, also in the morning? It can be so different with people. I am sure you don't have to choose between energy or sleep. It can take a while until you find the right meds. It happens to a lot of people.

I just found that my belief that medications are as much a blessing as natural remedies and psychotherapy and other healing things, like laughing or hugging girl friends, well, or love, that my belief and gratitude help a lot.
I am definitely happy to be taking medication. My life is so much better now.
Only recently I tried a simple exercise that I read about, and it is meant to help you change the focus on negative thoughts to good things. All you do, is in the evening make a list (mentally or in writing) of five things that were good that day, that went well or that you did well. I swear, I felt my brain change from doing that. I think I also read that after three weeks, one is quite used to doing it and the more good effects are showing.
It is also quite possible that your life has things that are tough for a sensitive person. There are over sensitive people and they tend to have a hard time.

How is your life going in general? I am curious because I had a friend who worked and lived in Saudi Arabia for a couple of years. He is Egyptian. Actually a pharmacist! I was married to an Egyptian man and I visited Egypt many times in the past. So I am very interested about life in other Arabic countries. Sorry it is a bit off topic, maybe we can talk through private messaging here. I got to check that out...

Good luck to you,

Lisa :):)

#17 Endlessnight

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Posted 03 April 2010 - 05:19 PM

Hello Lisa.  Thank you for your message.  I agree that attitude can make a big difference to our moods, and I know that my attitude is not a good one.  With regards to meds, usually if a med has a possible side effect I will get it!  I am back taking the Endep now and am sleeping well again though I have occasional nightmares.  But I love it that I fall asleep almost as soon as I put my head on the pillow.  Having had insomnia since I was a teenager I know how horrible it is to toss and turn all night trying to sleep.  I am trying very hard not to give in to the sweet craving that Endep gives me and so far i'm doing sort of okay, not great...but okay.  I have put on so much weight in recent months though and my breasts feel so swollen.  When I was taking the Ludiomil and the Amitriptyline my eating was out of control but lately it's gotten better, and I have been exercising four or five times a week for fifteen minutes for a couple of months now but I still seem to be gaining weight and it's really getting me down.  My clothes don't fit me!  I dont know what to do though as I don't want to stop taking my depression meds because they have made a difference in my moods.  Before I started taking them I would never have been able to come to a site like this one.  Anyway, i'm going to start taking only half the dosage of the Endep nightly and see if that helps with my weight problem.  If anyone has any other or better suggestions for me I would love to hear them.
M.




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