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Cat416: neophyte experience with medical system


Cat416

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Thanks ManyMoreTodays

very much appreciated here is my Drugs interaction report: Propranolol has no effect but the combo of Lexapro and Seroquel affects the heart. my Psych is very aware of this and says my low dose should mean I’m OK but he lowered the Seroquel out of an abundance of caution. The beta blocker and the lowered Seroquel have had an effect. My heart rate is down 

Drug Interaction Report

This report displays the potential drug interactions for the following 3 drugs:

  • Seroquel (quetiapine)
  • propranolol
  • Lexapro (escitalopram)

Edit list (add/remove drugs)

Major (1)
Moderate (1)
Minor (0)
Food (2)
Therapeutic Duplication (0)

Interactions between your drugs

Major

QUEtiapine  escitalopram

Applies to: Seroquel (quetiapine), Lexapro (escitalopram)

Using escitalopram together with QUEtiapine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

 

 

April 2019 ct from Clonazepan (Klonopin) 0.5mg. Chaotic CT

Gabapentin November 2019 600mg Chaotic RT

Nozinan November 2019. RT

ct Gabapentin and Nozinan May 2020

Seroquel in July 2020 90mg. Reduced to 50mg in Feb 2020 over one month. Too fast!!

Lexapro July 2020 5mg

Propranolol to control Tachycardia 2020. 15mg given in December 2020 on Cardiologist recommendation. 

 

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  • Administrator
Altostrata

Why was 5mg Lexapro added in July, Cat? How do you feel before and after you take it in the morning?

 

When did you reduce to 50mg Seroquel? Your signature simply says "Feb" so it's only been a week or so?

 

Yes, please provide more detail in your daily drug and symptom notes, post 24 hours at a time.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Hi Altostrata

 

i started the Seroquel (87.5mg) as well as the Lexapro at the same time in July 2019. The drugs were prescribed due to a chaotic rapid withdrawal from Gabapentin and Nozinan.

in December 2019, my psych started lowering the Seroquel because of Tachycardia and Akathisia. I tapered the Seroquel over December. My last reduction was 8 weeks ago now. I’m now at 50mg Seroquel, 5mg Lexapro and 15mg Propranolol. I’m struggling with especially fierce WD still. Although it’s lightened up a little over the last week.

 

10:00 pm I take 50mg Seroquel

7:30 am I take 10mg Propranolol 

8:30 am I take 5mg Lexapro 

12:00 I take 5mg Propranolol 

 

I do not feel anything bad after I take my pills. I notice no reaction to the Lexapro.

 

im thinking of starting to taper the Propranolol, then proceeding to the Seroquel then finally the Lexapro (Lexapro last because I have least trouble with side effects on it)

 

the symptoms I am currently struggling with are:

- waking up with Cortisol surges which last a long time...often until noon when it starts fading

- headaches

- nausea and malaise 

- burning/ tingling in arms, feet and face

- strange sensations in the brain

- general malaise 

- cold and hot sweats 

 

I am trying to work out whether to updose the Seroquel or not. A bit afraid to as the Akathisia problem may return. 
my only other alternative is to continue limping along until I hopefully stabilize. I am feeling very disabled and not able to live to engage in life normally. 
 

sometimes doing nothing rather something to “help” the situation can compound the problem. 
 

your perspective on the situation is appreciated. Do I wait this out and do nothing or try to do something?

Also, is my taper plan correct? Propranolol (to practise micro tapering), Seroquel which is giving me trouble and lastly Lexapro which does not appear to be giving me any trouble yet.

 

 

 

April 2019 ct from Clonazepan (Klonopin) 0.5mg. Chaotic CT

Gabapentin November 2019 600mg Chaotic RT

Nozinan November 2019. RT

ct Gabapentin and Nozinan May 2020

Seroquel in July 2020 90mg. Reduced to 50mg in Feb 2020 over one month. Too fast!!

Lexapro July 2020 5mg

Propranolol to control Tachycardia 2020. 15mg given in December 2020 on Cardiologist recommendation. 

 

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  • Moderator
manymoretodays
On 2/20/2021 at 11:02 AM, Cat416 said:

here is my Drugs interaction report: Propranolol has no effect but the combo of Lexapro and Seroquel affects the heart. my Psych is very aware of this and says my low dose should mean I’m OK but he lowered the Seroquel out of an abundance of caution. The beta blocker and the lowered Seroquel have had an effect. My heart rate is down 

 

Hi Cat416,

Hmmm, I spied moderate drug interactions between the propranolol and Seroquel too.

I'm just going to provide the link again to Your Drug Interactions

On 2/21/2021 at 6:54 AM, Cat416 said:

10:00 pm I take 50mg Seroquel

7:30 am I take 10mg Propranolol 

8:30 am I take 5mg Lexapro 

12:00 I take 5mg Propranolol 

 

I do not feel anything bad after I take my pills. I notice no reaction to the Lexapro.

 

im thinking of starting to taper the Propranolol, then proceeding to the Seroquel then finally the Lexapro (Lexapro last because I have least trouble with side effects on it)

 

the symptoms I am currently struggling with are:

- waking up with Cortisol surges which last a long time...often until noon when it starts fading

- headaches

- nausea and malaise 

- burning/ tingling in arms, feet and face

- strange sensations in the brain

- general malaise 

- cold and hot sweats 

 

And then, this is good ^.  I'd like you to go a bit further though with it.  Your narratives of symptoms and possibles in that post are good too.

For ease of getting a nice, objective view though, try one using a format like this:

The time of day, dosage, and severity of symptoms are essential information. Include

 

- Time and dosage for all drugs taken throughout the day, psychiatric and non-psychiatric.

- Following each dose, note any symptoms. If you are having a reaction to the drug, it may take hours for a symptom to show up -- that's why we ask you to keep notes all day long.

- If you're not taking any drugs, your symptoms throughout the day.

- Your sleep pattern. Since so many drugs disturb sleep, if you find you're waking in the middle of the night, it could be from a drug you took earlier in the evening. If you're not taking any drugs, there may be ways you can improve your sleep.

And so forth. A diary, in chronological order, looking something like this:
 

Example:


DATE:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

An appointments diary is perfect for this and can be bought at stationery stores. They have a page for each day with times for appointments which can be filled in with doses, symptoms etc as shown above. Or, you can copy and paste from a cell phone app -- but make sure the result is easily readable.

 

Please do not use spreadsheets, they are difficult to read online and some of us don't have Microsoft Excel to look at them.  You may link to a Google Doc or spreadsheet if you wish.


And then post 24 hour segments right here.  If you want to, add in to the right of the time, any non-drug coping done, and if it helped

 

Okay, best, and to better days for you, healing.

 

L, P, H, and G,

mmt

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016. 

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

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Thank you MMT!

I looked at the Propranolol interaction with Seroquel. It can apparently have reduce blood pressure significantly. Thus is definitely not one of my problems. I have the opposite problem: high heart rate and high bp.

 

I have gotten an appointments diary and will make note of symptoms on a 24 hour basis. Will post once I have some info. 

April 2019 ct from Clonazepan (Klonopin) 0.5mg. Chaotic CT

Gabapentin November 2019 600mg Chaotic RT

Nozinan November 2019. RT

ct Gabapentin and Nozinan May 2020

Seroquel in July 2020 90mg. Reduced to 50mg in Feb 2020 over one month. Too fast!!

Lexapro July 2020 5mg

Propranolol to control Tachycardia 2020. 15mg given in December 2020 on Cardiologist recommendation. 

 

Link to post

I am 57 and up until the introduction of psychotropic drugs I have been in excellent health. I had to go and see a cardiologist because my heart rate was so high (often as high as 170 bpm). The cardiologist said that the Seroquel was more than likely to blame. I don’t have QT interval problems or high bp. The Propranolol has definitely helped reduce the HR.

 

over the last five days the heavy ill feeling I am used to waking up with has lifted but now I seem to be cycling through a new phase of insomnia. It’s difficult to fall asleep. I’m getting maybe 3 hours of sleep a night. My psych wants to give me Trazzadone for sleep but I don’t want to add more drugs. Do I wait for sleep to settle before attempting to resume a slow taper? Afraid I’ll wait a really long time. Advice appreciated 

 

 

April 2019 ct from Clonazepan (Klonopin) 0.5mg. Chaotic CT

Gabapentin November 2019 600mg Chaotic RT

Nozinan November 2019. RT

ct Gabapentin and Nozinan May 2020

Seroquel in July 2020 90mg. Reduced to 50mg in Feb 2020 over one month. Too fast!!

Lexapro July 2020 5mg

Propranolol to control Tachycardia 2020. 15mg given in December 2020 on Cardiologist recommendation. 

 

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