Posted by yxibow on November 16, 2008, at 23:07:37
In reply to Is this person overmedicated?, posted by NKP on November 16, 2008, at 10:57:50
> A person that I know is on the following med regime:
>
> Mornings:
>
> 0.5 mg clonazepam
> 10 mg Buspar
> 60 mg fluoxetine
> 450 mg lithium
> 300 mg valproate
>
> Evenings:
>
> 0.5 mg clonazepam
> 10 mg Buspar
> 450 mg lithium
> 600 mg valproate
> 200 mg Seroquel
> 11.25 mg zopiclone
>
> I think she is overmedicated and getting worse on this med regime. Her cognition is badly affected since starting the lithium and valproate.
>
> She's so "out of it" she doesn't seem to realise what's happening to her.
>
> Any thoughts?
>
> Thanks.
This seems awful familiar -- shouldn't she be having this conversation with her doctor.I think all of us playing armchair psychiatrists without her years of history and diagnosis is particularly wrong for just a medication list.
Polypharmacy is necessary sometimes. I'm on polypharmacy and it is a mess sometimes, so are other people online. It takes a good savvy psychopharmacologist to really manage things well, but if this person's doctor has reasons for some of this then there are reasons.
The Seroquel may be causing some blunting, a change of affect which is natural with APs
The Klonopin doesn't seem particular abnormal
Depakote doses can be fairly high but this one may be a bit too high
Lithium is often energizing but may not be for some people, again doses can be high
The BuSpar probably is almost irrelevant because it only works for 30% of the people who take it at all. Can make you dizzy
The Prozac is normally energizing, but maybe not for this person.
The zopiclone, well Lunesta similarly can be taken for long periods
The only thing I can say is that there are several combinations of potentially CNS depressants stacked. That may be the cause of lethargy.That is not a reason for micromanaging someone else's medicine, not that I'm accusing that, I know you're concerned.
There are a lot of medications involved although I'm sure someone looking at my pad of paper would say what's this?
Talk to the person, ask them to have a real face to face talk with their doctor, bring in this pad of paper of medications, ask the reasons and state the side effect.
Psychiatry shouldn't just be a sit there and be given pills. Its a two way street.
-- best wishes
Jay
poster:yxibow
thread:863345
URL: http://www.dr-bob.org/babble/20081114/msgs/863512.html