Side Effect??

[Kathleen]

Hello;
I don't know if you guys remember but I was on cymbalta 60mg which threw me into a manic episode a little while ago. I eventually was taken off of it and I crashed. I took 30 immovane, woke up in the ICU then was moved to psychiatric for 4 weeks. Anyways, while I was diagnosed with bipolar and they were playing around with my medication a bit.

I am now out of the hospital and take 200mg lamotrigine and 350mg seroquil divided during the day. I also take 15mg immovane which isn't anything new. I am experiencing realy bad confusion. I all of a sudden lose my bearings and have no idea where I am or what I am doing or why I am doing it. I am sometimes in my own house and I get the "not knowing where I am" feeling. It is kind of scary. Do you think this could be because of the medication or do you think it is something else? I have been on the lamotrigine at this dose for 2 weeks, the same with the seroquil.

 

[David Baxter PhD]

Hi, Kathleen. Talk to your doctor about the Seroquel, both the dose and the timing of when you take the medication. Seroquel can be sedating for many patients and if you're splitting the dose rather than taking it (or most of it) at night that might be causing some daytime disorientation.

I also think you should check with your doctor about whjether you still need to take the Imovane while you're on Seroquel.

 

[Dragonfly]

It is kind of scary. Do you think this could be because of the medication or do you think it is something else?

Kathleen, I think that I can imagine how disconcerting it must be to suddenly lose your bearings or lose track of what you are doing / why. Clearly I can't comment on the way that your body metabolizes medications or even how the medications you are taking might interact - specifically in your body .... I do know that, in general, the meds that you list can easily cause mental confusion or clouding. I also know that often, the dose of medications people need while they are hospitalized is much higher than they generally need once they are reasonably stable and out of the hospital. That the dose of meds that it takes to stabilize things in the hospital will eventually cause side-effects once the person is stable. Kinda like if you were to break your leg and needed narcotic pain meds. At first, you would likely need a fairly high dose. Your body would tolerate the dose, because the pain you experienced needed the high dose of meds. But that after a few days, if you continued to take the same high dose, you would likely end up significantly sedated because your body's need for the meds has decreased. Again, in general, I have found that to be true when working with people and their psychiatric meds.

However, as I said, I don't think that anyone but you and your provider can work this out - as it specifically applies to you. When are you scheduled to see your provider? Anything you can do to move the appt closer? Take care.

 

[Kathleen]

I do not have a health provider. If I need to see a doctor I have to go wait up in the emergency department. The seroquil I take 50mg at 8am, 50 mg at 5pm and 250mg xr at bedtime. There is no walk in clinic around here, so I guess if it gets worse Ill have to wait at the ER.

 

[David Baxter PhD]

You might start with talking to your pharmacist. They are often a wealth of information about such things and you might get some excellent suggestions there. Otherwise, you probably should try to take the time to go into the ER and talk to a physician or psychiatrist there.

Who prescribed these medications originally? Do you have a contact number for that person?

 

[Dragonfly]

ummmm ..... Kathleen - who is going to prescribe your meds? At some point, isn't the prescription that you got from the hospital going to run out? Who is going to refill your meds at that point? (sorry to ask so many questions at once - I really don't mean to barrage you.) Anyway, could that person help you now?

 

[Kathleen]

i have no idea who is going to refill my meds. The worst thing too is that they only gave me 2 weeks worth knowing I dont have a doctor or anyone.

 

[David Baxter PhD]

I remember that your up north with few resources but surely they can't just give you that sort of medication and cut you loose without any followup. Do you know the name of the doctor you saw at the hospital? They must have some sort of outpatient service there.

 

[Kathleen]

Yes, I know the name of the doctor. He did just cut me loose without anything. I was at the hospital in North Bay, which is actually about 2 hours away from where I live. I have to go that far just to get help...I am telling you, there is nothing around here.

 

[David Baxter PhD]

I do understand that you are not in a good situation at all, Kathleen. Desperate times require desperate measures, though, and you have to do whatever you need to do to get medical attention. Can you telephone that doctor's office and make an appointment?

 

[Kathleen]

I tried calling on friday and they said he only deals with inpatient and I asked what I was supposed to do and they said it would be up to me to figure it out....Now I am thinking in 1.5 weeks I am going to be out of medication and I am going to crash huge again...I'm scared beyond belief but there isnt much i can do about it.

 

[David Baxter PhD]

I don't know what to say, Kathleen. It may well be that your only choice is to go back to the ER in North Bay and tell them you need a prescription because there are no available doctors in your community.

You can't just stop taking medications like the ones you've been prescribed. Any physician would know that.

 

[Kathleen]

I will talk to the public health nurse at the school and see if she can help me

 

[David Baxter PhD]

Good idea. She may have some workaround for you.

Good luck, Kathleen.

 

[Dragonfly]

Great idea! Hey Kathleen - is it possible that part of the mental confusion that you are / were experiencing (mental confusion is my term, I don't think you actually used this ....) is because of anxiety around getting your meds refilled? If this is even remotely possible, then you might have a great indication of what happens when you get anxious about meds .... Just wondering. Even I am completely wrong, I am impressed with your creative solution. Great job!