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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by MB on July 7, 2001, at 13:55:21
OK, I am addicted to caffeine; I need it to function. I have tried all SSRIs, Effexor, Remeron and Wellbutrin. Remeron put me in a figurative coma, and the rest made me absolutely bouncing-off-the-walls-murderously-crazed (unless I stayed on them long enough, then *they* put me in a depressed stupor). Anyway, caffeine (to get me out of bed) and 45+ minutes aerobic exercise/day seems to ward off any suicidal ideation (though I still spend a lot of time dysphoric and obsessive). Here's the deal: the caffeine seems to be working, but, like the SSRIs, it causes weird things to happen. At normal doses (i.e. one cup) I get racing thoughts and facial/diaphragmatic tics. At higher doses, I get extreme anxiety, paranoia and blue flashes of light around the periphery of my vision. OK, so the obvious answer is to quit the caffeine, but I just can't. The depression and inability to function (the complete lack of desire to live or function) without it is unbearable. Also, isn't that type of reaction to such little caffeine indicative that something *else* is wrong with me? Many people I know drink as much as 5-6 cups a day without problem. I'm afraid to take this complaint to a pdoc because I think they will want to put me on neuroleptics. I've tried Zyprexia before, and I think I hated it more than anything I've ever taken (other than, maybe, Remeron or allergy medicine). Also, doesn't the presence of a movement disorder (i.e. facial, diaphragmatic, and mental tics) predispose me for neuroleptic induced dyskinesias?
Posted by Zo on July 7, 2001, at 16:14:02
In reply to Caffeine reaction--can anybody help?, posted by MB on July 7, 2001, at 13:55:21
Almost sounds like the mix I've got, which is ADD, TLE, migraine, possible Bipolar II. . All of which rather overlap, and have in common a phenomenon known as Kindling. . .and suggest not enough dopamine in the frontal lobes, and perhaps too much bombarding the limbic system. Everything was hugely eased and levelled for me by, first, Dexedrine, which gave me both mental clarity and mental organization. . and then Neurontin, which evened out my moods and sleep. I bombed out on SSRIs, loved Zyprexa but it ruined my insulin response. . .Don't sense you need to turn to the APs yet, sounds like there's some basics to get in place first. Do you have migraine? Are you ADD and/or Bipolar II? Say more.
Zo
Posted by SalArmy4me on July 7, 2001, at 16:18:00
In reply to Caffeine reaction--can anybody help?, posted by MB on July 7, 2001, at 13:55:21
Actually, the atypical neuroleptic Risperidone is supposed to be pretty useful in movement disorders:
Lombroso, Paul J. MD et al. Risperidone Treatment of Children and Adolescents with Chronic Tic Disorders: A Preliminary Report. Journal of the American Academy of Child & Adolescent Psychiatry. 34(9):1147-1152, September 1995.
And Olanzapine is useful in Tourette's Disorder, in which tics can be quite severe:
Semerci, Z. Bengi M.D.. OLANZAPINE IN TOURETTE'S DISORDER. Journal of the American Academy of Child & Adolescent Psychiatry. 39(2):140, February 2000.
6. Karam-Hage, Maher M.D.. Ghaziuddin, Neera M.D.. OLANZAPINE IN TOURETTE'S DISORDER. Journal of the American Academy of Child & Adolescent Psychiatry. 39(2):139, February 2000.
Posted by MB on July 7, 2001, at 19:24:09
In reply to Re: Caffeine reaction--can anybody help?, posted by Zo on July 7, 2001, at 16:14:02
< snip >
. . .Don't sense you need to turn to the APs yet, sounds like there's some basics to get in place first. Do you have migraine? Are you ADD and/or Bipolar II? Say more.
>
> ZoZ0,
I do not have migraines, thank god. I don't think I have ADD because when I took a test called the TOVA (a test where you have to click a button every time a square appears) I was impulsive and clicked even when there was no square. According to the doc, ADD people do the opposite: they space out and don't click when the square appears. Also, stimulants make me worse...make it harder to focus, give me racing thoughts, and tics (the SSRIs give me all these problems too). I don't know about bipolar disorder. I've never had a euphoric manic attack. I have had episodes of extreme irritablility and racing thoughts, but it was dysphoric...like like a really speedy anxiety/depression.
Posted by MB on July 7, 2001, at 19:54:46
In reply to Re: Caffeine reaction--can anybody help? » MB, posted by SalArmy4me on July 7, 2001, at 16:18:00
> Actually, the atypical neuroleptic Risperidone is supposed to be pretty useful in movement disorders:
I just watched "Metabolic Effects of Atypical Antipsychotics." No thanks. I still haven't lost the 30 lbs I gained on Paxil. I don't need to gain an additional 20-30% of my present weight. I've tried Zyprexia...well, I tried half a tablet...and slept for two days and was worthless for about five (from one tablet). I sure had no trouble eating while I was awake, though. Felt very similar to Remeron. It was like, "I'm lying down right here on the floor, I don't care where I am, and I'm not moving ever!" It was almost as bad as Remeron, but not nearly as bad as amiltryptaline in terms of making me "paralyzed" for days from one pill. I don't know how the sedation of Resperdal compares to that of Zyprexia, but a schizophrenic friend of mine sure got fat on Risperdal. I don't know much, but I know that I can *function*, albeit strenuously, the way I am now. I can't even get up off of the floor on antipsychotics or anything that blocks histamine to any degree (Zyrtec, the non-drowsey allergy medicine, also incapacitated me). I wish they would come up with a medication that alleviated the symptoms of mood disorders without making you sick, crazy, fat, bald, hapatatoxic, or hypothyroidic. I don't think I will know what's wrong with me until I see where my baseline is without caffeine...but the depression gets too severe when i try to quit.
Posted by SalArmy4me on July 7, 2001, at 20:01:40
In reply to Re: Caffeine reaction--can anybody help?, posted by MB on July 7, 2001, at 19:54:46
How do you even know that the doc is going to prescribe something like Risperdal or Zyprexa? Go see a doctor anyway, por favor.
> > Actually, the atypical neuroleptic Risperidone is supposed to be pretty useful in movement disorders:
>
> I just watched "Metabolic Effects of Atypical Antipsychotics." No thanks. I still haven't lost the 30 lbs I gained on Paxil. I don't need to gain an additional 20-30% of my present weight. I've tried Zyprexia...well, I tried half a tablet...and slept for two days and was worthless for about five (from one tablet). I sure had no trouble eating while I was awake, though. Felt very similar to Remeron. It was like, "I'm lying down right here on the floor, I don't care where I am, and I'm not moving ever!" It was almost as bad as Remeron, but not nearly as bad as amiltryptaline in terms of making me "paralyzed" for days from one pill. I don't know how the sedation of Resperdal compares to that of Zyprexia, but a schizophrenic friend of mine sure got fat on Risperdal. I don't know much, but I know that I can *function*, albeit strenuously, the way I am now. I can't even get up off of the floor on antipsychotics or anything that blocks histamine to any degree (Zyrtec, the non-drowsey allergy medicine, also incapacitated me). I wish they would come up with a medication that alleviated the symptoms of mood disorders without making you sick, crazy, fat, bald, hapatatoxic, or hypothyroidic. I don't think I will know what's wrong with me until I see where my baseline is without caffeine...but the depression gets too severe when i try to quit.
Posted by Zo on July 7, 2001, at 20:13:22
In reply to Caffeine reaction--can anybody help?, posted by MB on July 7, 2001, at 13:55:21
Tic behavior is common with ADD. . .see Ratey's Shadow Syndromes. Am not so sure about that TOVA, I'm ADD-impulsive. . and I would have over-pushed too!
As for the atypical APs. .. it's another case of YMMV - your mileage WILL vary. . .. I did so well on Zyprexa, but gained too much weight. Others gave gained *none.* Tried Geodon, its new competitor, only made me fatigued. Hard to say any one med is useless, one must simply plod thru them all, do a lot of reading, use your intuition, hopefully with a good and interested pdoc to help.
Posted by MB on July 7, 2001, at 21:25:45
In reply to Re: Caffeine reaction--can anybody help?, posted by SalArmy4me on July 7, 2001, at 20:01:40
> How do you even know that the doc is going to prescribe something like Risperdal or Zyprexa? Go see a doctor anyway, por favor.
You're right, I don't know that the doc would do any of this. I don't know why I'm so nervous to go back to see a pdoc. I don't want to feel like this anymore, but I'm afraid to get back on medication. Some days, I feel fine, other days, I'm like death warmed over. I went to see the GP to see if there are ay physiological problems, but my bloodwork came back normal. I will do some research looking for a competent pdoc, but I still think the whole ordeal is really scary.
Posted by MB on July 7, 2001, at 21:31:50
In reply to Re: Caffeine reaction--can anybody help? » MB, posted by Zo on July 7, 2001, at 20:13:22
> Tic behavior is common with ADD. . .see Ratey's Shadow Syndromes. Am not so sure about that TOVA, I'm ADD-impulsive. . and I would have over-pushed too!
>
> As for the atypical APs. .. it's another case of YMMV - your mileage WILL vary. . .. I did so well on Zyprexa, but gained too much weight. Others gave gained *none.* Tried Geodon, its new competitor, only made me fatigued. Hard to say any one med is useless, one must simply plod thru them all, do a lot of reading, use your intuition, hopefully with a good and interested pdoc to help.Yeah--I guess I shouldn't put down a whole class of medication. It's just my experience that each new one to come out is puted to have all the therapeutics with fewer side effects...then I take it and it's no different. I think I will call the Amen clinic back Monday. I got really freaked out and didn't call them back (they're the people that do the SPECT scans). If I could see a picture of my brain, and have someone say, "look here, this is what's wrong and here's what to take," I'd feel better. This guinnea-pig trial and error thing is so time consuming. I have to go back to school in September, I don't want to be incapacitated by the wrong med. At least now, I know I can just drink enough coffee to get manic, and get pretty decent grades (although I still pace and break things). If I take the wron med I might just become too dumb for school.
This is the end of the thread.
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