☼ LilBit: polypharmacy nightmare

[LilBit]

15 hours ago, Songbird said:

 

You can get sublingual vitamin D3 tablets.

 

I may try that.  I am just afraid that I will run into the same issue since I am so sensitive to the drops, but who knows!

[LilBit]

Thanks for the advice Shep...  It seems like the new concern now is that the Vitamin D is activating, causing GI disturbances and increased insomnia.  If that's the case I am not sure how I am going to get my levels up.  That between all of my other symptoms (with new ones creeping up almost daily) has me a bit anxious.  I can really feel how tired I am today and it is discouraging, but hanging in there.  

[LilBit]

Sorry to seem like I am catastrophizing but I feel really terrible now and am suffering... my vision is even blurrier, I am having trouble even typing on the keyboard, and am beyond tired and exhausted for some reason.  This is probably TMI, but I had diarrhea twice this morning and had to go pee 4 times already... this isn't life, this is misery.  I would even go out on a limb to say that I feel just as bad if not worse as when all of this started.  I am really desperate here. 

[Altostrata]

Vitamin D can be activating, if you suspect it is, take less or stop it. It is a daytime vitamin, don't take it at night.

 

You may feel awful because you got poor sleep for a couple of nights.

 

5 hours ago, LilBit said:

 

Oct 29

 

Did not sleep too well last night.  Suspecting it may be the Vitamin D.  Was not as sleepy and woke several times.

 

137 lbs

 

9:30am  500mg depakote, 400 IU vitamin D

10:30am  abdominal pain, stomachache

11:15am  bowl of cereal

12:10pm  palpitations

1:00pm  strawberry yogurt

2:00pm  brain fog 

3:30pm  grilled chicken with fried brussels sprouts 

4:00pm  increased brain fog

7:30pm  fish tacos in corn tortillas with corn and coleslaw 

8:50pm  brain fog lessened

10:00pm  stomachache/abdominal pain

11:15pm  bedtime, had difficulty falling askeep

1:00am, 2:30am, 4:30am woke up

6:00am woke up

6:30am got up for the day, got about 4 hours of sleep

 

 

Please be sure to include ALL drugs and their dosages in your notes. You didn't skip quetiapine and diazepam on October 29, did you?

 

Yes, tapering quetiapine is probably a good idea, but I am worried about that abdominal pain etc, you're still getting after taking Depakote in the morning. Can you move your bowl of cereal up to 9:30 a.m. and take the Depakote with food?

 

Please consider whether, when you see a psychiatrist, you may not express yourself in a catastrophizing way, dramatizing your condition. Doctors are confused by emotion. This may be why you end up getting so drastically overdrugged on these absurd cocktails.

 

Strongly suggest the next time you see your psychiatrist, you ask her why Depakote is a good choice for you. I suspect it's a "shut up pill." Do not unintentionally lead your psychiatrist to prescribe "shut up" pills by making a lot of noise.

 

Unless you are some kind of extreme case, there is no rational reason why you would need to take a dangerous drug such as Depakote, particularly since you seem to have an adverse reaction to it. Also, please remind her you still need periodic liver and kidney function tests, plus blood sugar tests for the quetiapine.

 

Also, please remind yourself that while you might sometimes feel low now, you came here after a zillion drugs had been bounced off your brain and now you're only on 3 drugs. Things have gotten better. You are finding your way out. Catastrophizing is not appropriate.

[LilBit]

 

Since the vitamin D oil seems to be causing these bad side effects, is there anything else you can think of that I can try?  Songbird suggested the sublingual tabs, do you think that would have a different effect perhaps?  I have been getting sun at every opportunity, even though we have had some rain recently. I am just concerned because my vitamin D is at low levels, which I can’t understand either because I have never had that problem before.  That’s a good idea regarding the Depakote, I’ll try taking it with my breakfast and see if that helps those symptoms.  I should have thought of that but sometimes I forget to think in the mindset of someone going through WD instead of what is okay for people who aren’t.

 

 I actually did take the quetiapine and the diazepam. I don’t know why I keep forgetting to put it in my notes, but I’ll definitely do a better job at remembering!   My brain really has not been working right the past several days. 🤔

 

 I am always calm when I go to see my current doctor. She actually is not the one who put me on the Depakote, it was the quack I was seeing before. She has actually been slowly tapering me off, as she also agrees that I don’t need to be on it. Her goal is to get me off all of the drugs that I am currently on, and I have explained to her my desire to taper slowly. So far she seems to agree, although her definition of “slowly” is slightly different from mine, but I am working on that.   I will most certainly remind her of the tests. Fortunately I’ve had all those things recently checked, so I know they are fine.

 

 Thank you for the encouraging words Alto. Sometimes it’s hard, especially when the waves are more frequent than the windows, and the waves seem worse than the original symptoms, but I do need to remind myself of that. When I look back at my signature, it horrifies me just how many drugs I was on. I still have a plastic grocery bag full of all of the pill bottles as a reminder once I get past this, just how crazy that Dr was and the hell I went through so I can warn and educate others.

 

 

[Altostrata]

You may be sensitive to vitamin D now, you might be able to take it later. You might be able to find a lower dosage you can tolerate now.

 

I am thinking you might reduce the quetiapine one more time, than hold on that and taper off Depakote.

 

There are other ways to taper Depakote. Zant is quite the expert on Depakote Sprinkles.

 

 

Depakote Delayed-Release Sprinkles come in a 125mg capsule, to be opened up. You may be able to substitute 125mg Sprinkles plus 75mg out of another capsule to add to a 250mg tablet to bring your total dosage up to 450mg per day, for a 10% decrease. Or, you can get Depakote Delayed-Release Sprinkles compounded in 200mg capsules to add to a 250mg tablet for a total of 450mg per day.

 

Please ask your doctor her plan for tapering you off Depakote, as it seems you still have an adverse reaction, and it doesn't seem to be doing anything good.

 

When you speak to your doctor, do not ask her permission to taper, tell her you want to taper.

[LilBit]

Oct 30

 

136.8 lbs, Again did not sleep well last night, feeling very tired and drowsy this morning.

 

9:30am  500mg depakote, 400IU vitamin D

9:45am  bowl of cereal 

10:15am  diarrhea

11:00am banana

2:50pm  diarrhea

3:30pm  grilled chicken breast with carrots

7:30pm  baked salmon with asparagus 

8:00pm  strawberry yogurt 

9:00pm  aches and pains in body

9:30pm  22.5mg Quetiapine, 2mg diazepam 

11:00pm bedtime

12:30am, 1:30am, 3:30am, 5:00am woke up

6:30am got up for the day, about 4 hours of sleep

 

 

Oct 31

 

135.8 lbs   I feel a bit sick and jittery this morning.

 

9:20am  breakfast - bowl of cereal

9:30am  500mg depakote, 200IU vitamin D

10:30am  urine - clear/pale

10:35am  BP 116/82

10:40am  nausea

11:10am  urine - almost clear

12:05pm  urine - pale yellow/clear

12:15pm  snack - mixed berry yogurt

1:00pm urine - low output and yellow/clear

2:00pm lunch - cobb salad with grilled chicken

2:50pm  urine - almost clear

3:50pm  urine - almost clear

6:00pm  urine - small amount, light yellow

6:10pm  snack - 2 slices of cheese

6:30pm  dinner - 3 small beef fajitas with cheese and corn tortillas 

8:30pm  palpitations

8:50pm  urine - light yellow/weak stream

9:30pm  22.5mg Quetiapine, 2mg diazepam 

10:45pm  Bedtime

12:10am, 2:00am, 4:00am, 5:30am woke up

6:00am  got up for the day, got about 4 to 4 1/2 hours of sleep

[Altostrata]

Why are you concerned about your urine output?

[LilBit]

Sorry, I was tracking it one day to see the consistency/frequency for my urologist due to the urinary urgency/retention.  I am keeping that in a separate log now.

[LilBit]

Nov 1

 

135.6 lbs, loose BM

 

Did not sleep well again last night, got about 4 to 4 1/2 hours of sleep.  I am also showing more visible signs of weight loss, especially in the arms/hands.  I feel extremely exhausted this morning with very little energy.

 

8:30am  stomach cramp/nausea

8:45am breakfast - blueberry muffin, banana, cup of milk (400 cal)

9:30am  500mg Depakote

1:30pm  lunch - chicken sandwich with fries and lemonade (500 cal)

2:30pm  palpitations 

8:00pm  dinner - seafood stuffed salmon with asparagus (580 cal)

9:45pm  22.5mg Quetiapine, 2mg diazepam 

10:45pm  bedtime

1:00am woke, hard time falling back asleep

3:30am, 5:00am woke up

6:00am woke for the day, only got 3 hours of sleep.  Seems like sleep is getting worse for some reason.

 

 

Nov 2

 

136.2 lbs, loose bm

 

8:00am  breakfast - yogurt, banana, OJ (300 cal)

10:20am  bacon and egg sandwich (490 cal)

10:40am  500mg Depakote

1:30pm  grilled chicken sandwich (500 cal)

4:45pm  small cookie dough shake (420 cal)

7:00pm  slight nausea

8:00pm  dinner - bbq salmon with mashed potatoes and green beans (510 cal)

9:40pm  22.5mg Quetiapine, 2mg diazepam 

11:20pm  bedtime

1:45am, 4:00am, 5:00am woke up

6:30 got up for the day, got between 3 and 3 1/2 hours of sleep

 

 

Nov 3

 

136.2 lbs, loose bm

 

9:45am  breakfast - bowl of cereal  (250 cal)

9:45am  500mg Depakote

12:00pm  brain fog

1:45pm  lunch - santa fe eggrolls with side salad (600 cal)

3:00pm  slight brain fog

6:30pm  dinner - cracker barrel chicken and rice with broccoli and corn (840 cal)

9:30pm  22.5mg Quetiapine, 2mg diazepam 

10:20pm  bedtime

11:40pm, 1:00am, 1:40, 4:00am, 5:30am woke up

6:10am got up for the day, got 4 1/2 to 5 hrs sleep

 

 

Nov 4

 

136.4lbs  Loose BM

 

8:15am  breakfast - bacon egg and cheese taquito with small cinnamon roll and OJ (620 cal)

11:00am  500mg Depakote

2:30pm  Cheese enchiladas with Mexican rice, beans, grilled chicken breast, avocado and salad (1200 cal)

3:00pm  palpitations

5:00pm  palpitations

6:00pm  palpitations

7:00pm  Smoked turkey sandwich (330 cal)

9:30pm  22.5mg Quetiapine, 2mg diazepam 

11:00pm  bedtime

1:00am, 4:00am, 5:00am  woke up

6:15am  got up for day, got about 3 1/2 hours sleep

 

[LilBit]

I don't know why, but today I am feeling very depressed and panicky.  I am worried about my weight loss and insomnia, and made the mistake of calling several friends because I needed somebody to talk to.  Of course they probably think I am crazy and overreacting, and I am sure they are tired of hearing about it by now because it is all I talk and think about lately.  This has really consumed my life and I am trying my hardest to think positively and not let it control me but it is so difficult.  

[Altostrata]

Your next quetiapine reduction is coming up soon. How about reducing to 20mg?

 

Have you given thought to how you're going to reduce Depakote? I think it's still upsetting your stomach, and maybe causing those palpitations.

[LilBit]

I think that sounds like a good idea.  I also agree that the Depakote is doing more harm than good, so tapering down using the Depakote Sprinkles sounds like the way to go.  Do I need to taper off of Depakote by 10% per month just like all of the other drugs?  I think it is also causing the loss of appetite as well.

[Altostrata]

Yes, you need to start tapering Depakote by 10%. The first step will be a reduction of 50mg.

 

Please confer with your doctor about how to compose this dose of 450mg. Sprinkles plus tablet is one way.

[LilBit]

Ok thank you Alto, I will do that, thanks as always for the advice... I hope this month has been treating you kindly so far.  I know it's been discussed many times on these forums, but if my calculations are correct, it will take 10 years to get off of all 3 drugs I am currently on at 10% per month per drug.  Does that sound right?  I will be 50 years old before I am even drug free if that is the case, not even considering post drug withdrawals after, which causes me LOTS of anxiety when I think about that (and that is assuming the tapers all go well, which given my polydrug history may not most likely be the case).  I hope you tell me that I am mistaken.

[Songbird]

I've found it best to not even think about a total time-frame for any of this, but just take it one step at a time.  Being drug-free is a good goal, but I think it's also good just to be on a lower dose, with fewer side effects.

[LilBit]

I know you are absolutely right Songbird, it’s just tough to wrap my mind around this whole thing, even a few months later.  Today I am feeling so weak and tired, like I am totally wiped out of all energy.  It’s like my body is burning up all this energy and I see my arms, legs and face getting skinnier.  I know it sounds weird, but I feel burning and tension in arms/legs, almost like I can feel it happening.  I’m not quite sure what’s happening to me but I can’t remember the last time I felt this terrible.

[LilBit]

I am actually starting to consider maybe CFS/ME.... I have an abdominal/pelvic CT with and without contrast scheduled for tomorrow just to rule out any other underlying causes.  I have been experiencing constant nausea and severe diarrhea for the past 3 days now, but have not changed my diet.  My fatigue has become extreme and I am losing all of my subcutaneous fat, which is making me look even more sickly.  Maybe my adrenals are out of whack?  Perhaps they need to check my aldosterone levels?   Not really sure at this point but growing concerned as it continues to progress.  CFS would definitely explain most of my symptoms.

[LilBit]

Nov 5

 

136.2 lbs  loose bm/diarrhea

 

Feeling very weak and tired this morning. Not sure why I am continuing to lose weight and having all of these difficulties with sleep. Feeling extremely helpless things will get better. Started getting very emotional with crying.  It has been for months and I feel like there’s been very little improvement.  Seems like tinnitus has gotten worse in my left ear over the past week or so.  I’ve also had palpitations all throughout the day today.

 

9:30am  bowl of cereal and banana (400 cal)

9:30am  500mg Depakote

12:30pm  abdominal pain/stomachaches

2:10pm  diarrhea

2:30pm  Mixed berry greek yogurt (110 cal)

3:45pm  Turkey original sandwich from Schlotzsky’s (590 cal)

6:20pm  diarrhea

6:40pm  nausea

8:00pm  salmon with broccoli (450 cal)

9:00pm  greek blueberry yogurt (110 cal)

9:30pm  22.5mg Quetiapine, 2mg diazepam 

9:45pm  banana (100 cal)

10:45pm bedtime

12:00am, 1:30am, 4:45am, 5:50am woke up

6:30am got up for the day, got about 4 hours sleep

 

 

Nov 6

 

135.4 lbs, loose bm/ diarrhea

 

Not sure why I am still having the problems with diarrhea when I have stopped the Vitamin D.  Everything was normal a couple of weeks and gradually got worse.  Also, had aches and pain when laying on my side last night which I think contributed to my insomnia.  Again with the palpitations throughout the day.

 

 

9:30am  breakfast - bowl of cereal, blueberry muffin, cup of OJ (520 cal)

9:45am  500mg Depakote

1:15pm  lunch - chicken sandwich with chopped tomatoes (450 cal)

3:45pm  nausea

4:00pm  snack - strawberry greek yogurt (120)

4:15pm  diarrhea

4:20pm  12oz cranberry juice (80 cal)

5:45pm  chicken salad (300 cal)

6:10pm  diarrhea 

7:35pm  palpitations

7:40pm  mild chili and white rice (400 cal)

8:00pm  banana (100 cal)

9:45pm  22.5mg Quetiapine, 2mg diazepam

10:30pm  bedtime

12:45am, 3:15am, 5:30am woke up

6:00am got up for the day, got about 5 hours of sleep

 

 

Nov 7

 

135.4 lbs, (18% body fat, 55% water, 5.5lbs bone), diarrhea

 

 

10:00am  500mg Depakote

10:40am  bowl of oatmeal, banana, OJ (500 cal)

12:30pm  diarrhea

3:10pm  blueberry muffin (240 cal)

4:40pm  baked potato soup (550 cal)

5:15pm  chicken pot pie (500 cal)

6:00pm  brain fog

7:30pm  3 scrambled eggs and cup of milk (350 cal)

9:30pm  22.5mg Quetiapine, 2mg diazepam 

10:00pm bedtime

1:00am, 2:30am, 5:00am, 5:30am woke up

5:50am got up for day, got about 4 hours of sleep

 

[Altostrata]

You should, of course, make sure you don't have any medical condition that's making you ill.

 

However, we know from your symptom pattern that you continue to have an adverse reaction to Depakote. If I were you, I'd stop procrastinating and start reducing it.

 

Why are you on a low-calorie diet? Eat more and put butter on everything!

 

Rather than worry about the future, look it how far you've come, you're only on 3 drugs now. As you reduce them, whatever effects they have on you will get less and less.

[LilBit]

Oh trust me Alto, I want to start reducing it! I am worried that my pdoc is going to want me to taper much much faster than recommended and will really question my choice of using Depakote Sprinkles for a very slow taper.   With the diet I am just trying to avoid foods that seem to bring on symptoms, and I have high cholesterol which my cardiologist has started nagging me about.  I also have a history of kidney stones so have to avoid certain foods with that as well. Lucky me!  😊  I am trying to see what I can do to add more calories to my diet.

 

I am glad that my drug burden is steadily decreasing, it’s the side effects that do concern me.  This weird loss of subcutaneous fat has also concerned me along with the insomnia and fatigue, but rolling with the punches.  Hope you have been doing well.

[Altostrata]

Your psychiatrist is a consultant you have hired to work with you. You will need to state, calmly and confidently, that you want to taper in a particular way.

[LilBit]

 So I received the results from both my upper endoscopy and my abdominal CT scan.  On the endoscopy, the polyps that were found were benign, and it looks like everything came back normal, no sign of celiac or H. Pylori or anything else.

 

The abdominal CT however was a different story. They found a 4 mm lesion on my liver as well as two smaller lesions, but the doctor is saying they are not concerned about this. I am, because this combined with the elevated SGPT definitely makes me suspect that the Depakote is causing this. I am almost afraid to do a very slow taper because I think it’s causing this, my upset stomach and diarrhea, lack of appetite, heart palpitations, and contributing to my insomnia.

 

They also found a cyst on my right kidney that has grown slightly in size,  so they want to do an ultrasound of that just to be sure everything is okay.   One other thing they mentioned which was very interesting, is that previously I had fat infiltrating my liver and they said this was all gone. The doctor’s exact words were “we had to make sure that we had the correct patient because it was so unusual that the fat just all disappeared“.  Maybe because I changed my diet and am now losing weight?  I just worried that if I stay on the Depakote too long that it is going to cause a lot more harm.  Lately I feel very tired and my body is achy with chills also. Trying to hang in there and remind myself that this is temporary and will pass.

[LilBit]

Actually I just looked back at my journal and I have been having the palpitations since July 9, so not sure if depakote is the cause but I know it definitely can’t be helping.  Depakote is also linked to Vitamin D depletion, which I have as well.

[Altostrata]

Now you know why you are feeling so ill and losing weight.

 

At the very least, if I were you, I'd lighten the Depakote burden. Please talk to your psychiatrist on Monday about getting Depakote Sprinkles so you can lower the dosage to 450mg per day. If all goes well for a week or two, an accelerated taper of 25mg every week might be a good idea, until you get to 250mg. Then, let's see how you're doing.

 

The diazepam is not that much of a worry for your kidneys and liver.

 

You should send a letter of complaint to your state medical board about whatever doctor prescribed you all those drugs since July 2017, detailing your psychiatric drug history and liver and kidney results, with a copy to the physician.

[LilBit]

Thank you Alto, I will try doing that.  I am very concerned as my GI symptoms have taken a drastic turn for the worse over the past week as well as my insomnia.  Now I feel like my stomach is constantly churning and making noises which it wasn’t doing before this past week.  I have a follow up with my GI doctor today.  I really don’t feel well at all and very weak and tired but trying to hang in there.  I literally feel like I am falling apart.

 

I filed a complaint with the state medical board a while ago and never heard anything back, so I will plan on following up with them.  

[LilBit]

Nov 8

 

136.4 lbs. Feel like I am in a daze and very tired.  Having abdominal CT with contrast today due to fatigue, weight loss and diarrhea.

 

6:45am  Bowl of cereal  (300 cal)

7:30am  loose bm/ diarrhea 

9:10am  500mg Depakote 

10:00am  nausea

12:20pm  diarrhea 

12:50pm  nausea

2:15pm  grilled chicken sandwich and fruit cup from chick fil a (400 cal)

6:30pm  caspian from mod pizza (790 cal)

7:30pm  diarrhea

9:00pm  banana (100 cal)

9:30pm  22.5mg Quetiapine, 2mg diazepam

11:00pm bedtime

1:30am, 3:15am,  4:30am, 5:30am, 6:00am woke up

6:30 got up for day, 4 hours sleep

 

 

Nov 9

 

Still experiencing myalgia, diarrhea, subcutaneous fat loss.  Trying a lighter diet today to see if it helps with the severe diarrhea.

 

136.2 lbs (18% fat, 23.3 BMI, 5.5% bone, 55% water), diarrhea

 

7:30am  breakfast - oatmeal with banana (400 cal)

8:00am  diarrhea 

9:15am  500mg Depakote

12:30pm  bowl of oatmeal (160 cal)

5:10pm  2 slices of toast (150 cal)

6:00pm  1/2 chicken breast with white rice (300 cal)

8:45pm  applesauce (50 cal)

9:40pm  22.5mg Quetiapine, 2mg diazepam 

9:50pm  brain fog/lightheaded

10:20pm  2 slices of toast with honey (200 cal)

10:40pm bedtime

12:00am, 5:20am woke up

6:15am got up for the day, about 5 hours sleep

 

 

Nov 10

 

135.4 lbs (18.3% body fat, 55.3% water, 23.1 BMI, 104.3 lbs muscle, 5.5 lbs bone, 3037 kcal)  small, soft bm.  Consumed 1600 cal.

 

8:30am  brain fog

9:00am  1 cup plain oatmeal (175 cal)

9:15am  banana (105 cal)

9:30am  500mg Depakote

12:30pm  1 cup applesauce (180 cal)

2:00pm  banana (105 cal)

3:00pm  3 scrambled eggs, 1 cup grits and 2 slices of toast (620 cal)

8:00pm  chicken breast and cup of rice (420 cal)

9:30pm  22.5 Quetiapine, 2mg diazepam 

10:40pm bedtime

11:50pm, 1:20am, 3:30am, 4:10am, 4:30am, 5:20am woke up

6:20am got up for day, got about 3 hours of sleep.  The body aches, stomach cramps, diarrhea and chills seem to be getting worse.

 

 

Nov 11

 

134.8 lbs, consumed about 1800 calories today.

 

7:45am  diarrhea/cramps/gas

9:30am  500mg depakote

10:00am  brain fog/tiredness

11:00 am  bowl of oatmeal (320 cal)

11:15am  pain in lower right abdomen 

1:00pm nausea

1:15pm  banana (105 cal)

2:30pm  half chicken breast with cup of white rice (300 cal)

3:00pm  diarrhea

3:05pm  applesauce (90 cal)

5:30pm  whataburger grilled chicken patty melt with apple juice (620 cal)

7:30pm  2 blueberry muffins (240 cal)

8:45pm  greek mixed berry yogurt (120 cal)

9:30pm  22.5mg Depakote, 2mg diazepam 

10:30pm  bedtime, fell asleep within 20 min

1:30am woke up, tossed and turned rest of night and think I got another 30 min to an hour of sleep.

6:15am  Got up for the day.  Got about 3 hours of sleep.

 

[LilBit]

 I saw the gastroenterologist yesterday and after describing my symptoms, he wants me to try taking Xifaxan 550mg twice a day for 10 days just to rule out any infection, and then follow up on the liver enzymes in a month.  His explanation was that this would be a good route to go before doing any further tests.  He also had me do labs for the enzymes and for Hep A, B and C.  I am having an ultrasound done this week as well to follow up on the lesions found on the kidney and liver.

 

I tried reaching out to my pdoc regarding the Depakote Sprinkles but she is out of town for the next two weeks, so the office is going to relay the information to her and get back with me.

 

I am still feeling like the sleep problems are playing a huge role in my health and healing and I haven’t exactly been helping myself too much by being anxious and worrying sometimes, but am really trying to get better about that.  I know the gut and digestive problems are a combination of this and the WD, and I have tried a more gentle diet that is easier on the stomach, but am losing weight since I don’t seem to be getting enough calories.  It seems that when my partner is not around because he is at work, I get a lot more anxious and tend to ruminate more.  My deadline for returning to work is coming up the Monday after Thanksgiving and we have some decisions to make, so that is not helping much either.  I know this has to get better... my biggest problem has been my insomnia which continues to give me poor, fragmented and little sleep since this all started.  I am working with the DME provider to get my CPAP machine, so hopefully that will help somewhat.

[Altostrata]

LilBit, your liver and kidney are in danger. You need to reduce the Depakote. We've been talking about this for weeks.

 

Did you discuss this at all with the gastroenterologist??

 

What dosages of Depakote capsules do you have on hand? What prescriptions for Depakote are active at the pharmacy?

 

Are you are taking Depakote DR (delayed-release) or Depakote ER (extended-release)?  Depakote DR comes in 125mg and 250mg tablets, while Depakote ER comes only in 250mg tablets.

 

You need 125mg Depakote DR tablets to taper from 500mg to 375mg. I don't like this big of a drop, but it might be the best you can do if you can't resolve using Depakote Sprinkles, which come in only 125mg capsules.

 

(If you got Depakote Sprinkles, you could open the capsule and take half, or 62.5mg, to add to 375mg for a less steep reduction to 437.5mg Depakote.)

 

The gastroenterologist can prescribe 125mg Depakote DR tablets or even 125mg Depakote Sprinkles, it doesn't take your useless psychiatrist.

[LilBit]

I did tell him my concerns about the Depakote and how I plan on tapering.  He agreed that it was a good idea and didn’t mention anything else about it.  The only Depakote I have at the moment is Depakote ER in either 500mg or 250mg.  My next appointment with my pdoc is Dec 4th, after she is back in town.  I am going to call the GI doctor and see if he can send a script for the Depakote DR/Sprinkles.

 

The reason I haven’t tapered sooner is because I got a head start on the taper when we went from 1500 to 1000 to 500mg: I didn’t want her to know that in fear that she would accelerate the rest of the taper.  Just like with the other drugs I am on, I am on lower dosages than she realizes.

 

 

Alto, I am truly scared.  I have always been someone who is independent, intelligent, can get through tough times with willpower and is level headed.  I think 4 months of not getting more than an hour or two of sleep at a time could possibly have lasting damage and is causing very ill effects on me.  I am in a constant fog.  I find myself really struggling now to think and perform basic tasks.  I can remember how I was even a couple of months ago and I am not like that now.  I panic more often and try so hard not to.  I was on the phone with my partner and just the reassuring sound of his voice made me start to cry.  I promise I am not normally like this, which makes it that much more upsetting.  I found this article below on how chronic sleep deprivation affects the brain.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449441/

 

 

[LilBit]

I am still trying to stay positive and socialize with people and be there for them.  I know one of the best ways to take your mind off of your own problems is to be there for others.  I have been noticing my health declining however, and this does scare me.

 

We have a lot of financial stress as well with me being out on disability and my partner’s hours about to be cut at work.  On top of that he is trying to start a business, my mother is not doing well and we just recently relocated to another town right when all of this started.  I was seeing a therapist but I did not feel like I was benefitting feom our sessions at all so I stopped seeing her, and have yet to find another one.  I am really doing my best to hang in there.

[Altostrata]

If you don't trust that psychiatrist, you're either going to have to discuss it with her or find another doctor to do the prescribing, it doesn't have to be a psychiatrist.

 

Can you also get a prescription for 125 Depakote ER (are you taking ER or DR??) to combine with 250mg Depakote ER (are you taking ER or DR??) and 1/2 a 125mg Sprinkles capsule for a total daily dose of 437.5mg?

 

If not, when you get the Sprinkles, you'll be able to combine one 250mg Depakote ER (are you taking ER or DR??), one capsule 125mg Depakote Sprinkles, and 1/2 capsule Depakote Sprinkles, same total dose of 437.5mg.

 

You'll run out of 125mg Depakote Sprinkles before the end of the month, so you'll need to get another prescription.

 

If you can, save the extra 1/2 capsule Depakote Sprinkles, put it back in the capsule for tomorrow.

[LilBit]

I am taking Depakote ER.   I tried reaching out to the Gastroenterologist for the Depakote Sprinkles prescription, but he would not give me one since he isn’t the doctor who originally prescribed the Depakote.  He did not want to interfere with the treatment plan of the psychiatrist.

 

My psychiatrist did call me back this evening however, which completely caught me off gaurd.  I was in the middle of running an errand when she called but I knew I had better answer since she isn’t always the easiest to reach and she was out of town. I explained to her that I would like her to prescribe the Depakote Sprinkles so that I can taper.  Her response was take one in the AM and 2 in the PM for a total of 375mg.  I told her that I would rather take the 250mg Depakote ER with the Depakote Sprinkles and she hesitated for a moment, and said she doesn’t like the idea of mixing formulations but that was fine.  She then wanted me to take a 250mg Depakote ER with 125mg Depakote Sprinkles for a total of 375mg still.

 

I told her that I felt this was too much of a drop for me given my history and I would like to take 250mg Depakote ER with one and a half of the Depakote Sprinkles as you suggested for a total of 437.5mg, and she responded with saying that she could not endorse that because she doesn’t agree with only taking a partial dose of a sprinkles capsule and that I should be fine on 375mg.

 

At that point I just told her to send the prescription for Depakote Sprinkles to my pharmacy.  I didn’t want to argue with het on the phone but now I am not sure how to proceed.  I am going to probably have to find another psychiatrist in the middle of my disability case (again) which really stresses me out.  What are your thoughts on this?

 

Thanks for all of the help you’ve provided so far, taking your time to help me. My thinking and judgment is not the best at the moment so I apologize if I am missing anything you may have asked for or forget anything you may have previously told me.

[Songbird]

It's good that you were able to get the Sprinkles.  You might only need the half capsule for a couple of weeks as a step down between 500mg and 375mg.

 

It looks like you've been taking the whole 500mg dose a.m.  Why does she want you to split the dose between a.m. and p.m.?

[LilBit]

12 minutes ago, Songbird said:

It's good that you were able to get the Sprinkles.  You might only need the half capsule for a couple of weeks as a step down between 500mg and 375mg.

 

It looks like you've been taking the whole 500mg dose a.m.  Why does she want you to split the dose between a.m. and p.m.?

 

Honestly I have no idea... and I was so frustrated by the conversation that I did not even ask.  That is also totally out of character for me.  Of course I won’t be doing that, I’ll just combine for the total daily dose and continue taking it all in the AM.

[LilBit]

Also one more question Alto... in your opinion am I still safe taking the Xifaxan?