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Mental Health So tonight I start carbamazepine...

MagickalKat777

MagickalKat777

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Feb 4, 2004
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And I'm not happy about it. My doctor assures me that it's not as bad as I think it's going to be but I can't see how something that increases the elimination of diazepam is going to NOT hurt someone who is tapering.

The thing that sucks is that she will be able to monitor me and make sure I'm actually taking the medication so I have no choice or she could pull my Valium script and leave me screwed.

She's starting me at 100mg XR at night for a week then 100mg morning and night for two weeks then 1 tablet three times a day for 30 days.

Am I blowing this out of proportion or is this med really as bad as the rest? I offered oxcarbazepine as a compromise and she shot it down saying that there's not enough research on it and she can't monitor the levels like she can with carbamazepine. She said if I really can't handle it that she will do oxcarbazepine and she bumped my Valium up from 3.75mg twice a day to 5mg twice a day.

I don't know what to think about this but man if it wrecks the taper I've been on for the last year I think I'll kill myself because I'm already so miserable..
 
She wants me on a mood stabilizer because i broke down in her office. Well I don't know what she expects from someone who is so fucked up that he can't leave the house or do anything that he used to love without freaking the fuck out...
 
I don't know anything about the drug so I can't comment on that but it sounds to me like this person (your doctor) is not very respectful of your worries. Does she know that you are tapering the diazepam?

Do you feel like you are making any progress at all with your anxiety, Magic? Because if not, I would really urge you to find someone either in addition to or instead of this particular doctor. I wish that they would just come right out and call "mood stabilizers" "emotion flatteners". It may be that you decide to try something like that but if you are not making any progress with healing the roots of your fear then a medication is just going to be a band aid. On the other hand maybe it will be enough of a help to make it possible to rejoin your life a little more and you can build on that. Tough decisions. I'm sorry that you are in this place--it sounds exhausting.<3:(
 
She's been extremely patient with me, I've seen her for almost a year and she's not forcing me to taper faster even though she believes I should be able to. I know her heart is in the right place and I have shown over time that I have mood issues but doctors can never pin down what exactly the problem is. I will be diagnosed as bipolar by most doctors and then they see my mood even out on its own and don't know what to think.

I'm just scared of carbamazepine. I've heard so much bad about Tegretol. I know she wants to be able to monitor my levels because i keep quitting things before they have a chance to work because of side effects and don't always tell her up front. She's not dumb. She knows that I know how to get around taking meds that I don't want to take and I feel like the carbamazepine is her compromise before she starts insisting that I try the atypical drugs I haven't tried.

Getting a new doctor would be extremely difficult, especially one that will be on board with allowing me to continue tapering benzos at the slow rate I've been going or even give them to me at all. I've been anticipating problems in the future and so I've been sourcing Etizolam and flubromazepam but I don't want to use them if I don't have to. A gram of flubromazepam would last me a minimum of two months though if push comes to shove.

I might be freaking about the med for no reason. She started me on a dose so low that it's not even available in generic. Generally you start at 200mg twice a day, she started me at 100mg once a day.

I truly do think she is trying to help, its just that I know I scared her this last time because my breakdown involved telling her I've been downplaying my symptoms out of embarrassment of how bad things really are and not wanting to admit it to myself or anyone else and I told her that suicide is something that is always there as an option because of how miserable I am. She seems to believe that this med will help me and I guess I just need to trust her.....
 
I've decided that I'm not gonna take it.

I think my problem with my taper was because the Mylan diazepam is crap. I was in constant withdrawal and now that I went to a new pharmacy to get my scripts, they gave me Ivax/Teva and I have actually been feeling the Valium again. I was functional last night to the point that I got up and shaved, cut my hair, and I showered which is the first time in like a month my anxiety was low enough to do it.

I'm going to be more than a little irritated if all of this hell started because I switched from the Watson 10mg pills back last year at a small pharmacy to Mylan at Walgreens. It's hard to pin it down for sure but it makes sense given the time line from when I switched pharmacies to started drinking all the time because the Valium wasn't enough.

I figure if I go in there and I haven't increased my dose in a month, and I'm doing better, she won't push the tegretol issue.

I feel so much better but it really sucks to know that this whole time has likely been hell because Mylan has horrible quality control...!
 
Good shit dude, glad to hear it!
It's our choice to take what we feel comfortable taking. These shrinks honestly think they're helping because most have never had to take this garbage. The tegratal was a nightmare for me, that was after depakote was a nightmare for me. Do what u gotta do man! No one else can tell u how u feel on these meds, they always think they know better but they don't. I'm glad to hear you decided against it, I wasn't gonna post until u said you decided against it. I'm not a dr but I've been there dude and it wasn't worth the months outta my shit life just to make it more shit.
 
Good to hear that you are feeling better. That misery of not being able to do anything is pretty terrible. Perhaps in a week or so of improved mood writing down a plan to continue dealing with your mood disorder and taper would be good. You've been on solo diazepam at that level in the past and had issues, so setting out some changes this time with that knowledge could really keep things up. Behaviors and the like. It is hard sometimes not to be caught up in just feeling better.

Removing the whole carbamazepine issue , the sum of actions this month is that your diazepam went from 7.5mg a day to 10mg a day, with maybe a more effective Ivax/Teva pill. An increase from your taper.

Maybe try giving the Tegretol XR a shot. I know someone who transitioned from daily clonazepam and lorazepam for some sort of weird anxiety/OCD/bipolar thing and did very well. She probably wouldn't be considered a drug addict, for whatever that counts for. It could be absolutely not for you, but at least giving it a shot would clarify the issue. As you said, you keep quitting things before they have a chance to work because of side effects, going for the known side effects of diazepam.

Your psychiatrist seems pretty reasonable and communicative, increasing your diazepam in the self-described slow taper with the setting of starting a new medicine while knowing there is a tendency to avoid taking other medicines for an effective period of time. This was "her compromise" and she started it with clear intentions. In terms of suicide and depression, unilateral benzodiazepines are not well thought of. More of a longer term view. Trying out her suggestion might not be a bad idea.
 
I haven't actually taken the increased dose if diazepam and I don't plan to unless I have to. I hate back tracking and I already feel like crap for so little progress on a taper in a year...

I am thinking about the Tegretol... I don't know. It could be a magic bullet or it could be yet another psych me that pushes me into psychosis. I really don't want another inpatient stay and I certainly couldn't afford one if I lost it. If I start the Tegretol, I'll likely do 100mg for two weeks... Basically double each step that she outlined to make sure I don't have any stupid reactions. I got psychosis from the lowest dose of lithium they make and Geodon and Zyprexa make me trip balls... I have really messed up receptors. :/
 
Yeah, I understand the weird medication reaction deal. I was hospitalized on my second day of Abilify. Rather than a magic bullet, perhaps the Tegretol could be enough of a change to gain some traction. I don't think Tegretol is like lamotrigine, where the initial stages can sometimes be more stimulating for some people. I don't know...still something to consider though.
 
checktest said:
Yeah, I understand the weird medication reaction deal. I was hospitalized on my second day of Abilify. Rather than a magic bullet, perhaps the Tegretol could be enough of a change to gain some traction. I don't think Tegretol is like lamotrigine, where the initial stages can sometimes be more stimulating for some people. I don't know...still something to consider though.
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I actually liked lamictal but it was impossible for me to gauge if my rash on my face and neck was from it or something else since I've been known to have skin flare ups from time to time so I stopped it at like 150mg a day.

The only thing that concerns me with the Tegretol is its liver enzyme enducing causing my Valium to plummet. Even if it doesn't, studies showed that it can cut the half life in half which would mean I'd had to take it three times a day.

I guess the only real way to find out is to try it so I'll start it tomorrow night before bed. Who knows, maybe dropping my blood levels would actually be a good thing and just push me further along my taper since I've been stuck at 7.5mg for 2 months now.
 
Well tonight was my third time taking it now. I am tolerating it better than most things I've taken. Anxiety is high but it was high when I started it. Doesn't really seem to be worse.

I was really tired this morning and most of last night is a blank. I think that's pretty common when first starting an AED.

Nothing too terribly bad though. I had an anxiety attack earlier and my pulse wasn't fast which was odd but since most drugs, including benzos, increase my pulse I'm happy with it going back to normal.

Edit: well I got woken up this morning by horrible itching... Called the pharmacy, stop immediately, allergic reaction.

Man... Fml!
 
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Ugh Tegretol is the worst med i have ever taken in terms of side effects. I took it for 2 weeks then started getting crushing headaches and really bad nausea and vomiting. I stopped taking it but for about 2 weeks after i was still getting the really bad headaches and feeling sick constantly. That scared me off meds for months. I was scripted it for trigeminal neuralgia as it used to be and with many doctors still is the first drug of choice for treating TN. Not only did it not help at all but the side effects where awful.

Carbamazepine is one of those drugs that get's a bad rep even among doctors and Oxcarbazepine has replaced it for most of the uses carbamazepine has. Like carbamazepine it is still a enzyme inducer so you have to watch that. As for your allergic reaction like lamotrigine Carbamazepine still carries the risk of causing Stevens-johnson syndrome along with other nasty shit like a sudden drop in white blood cell counts. Hence the reason for the blood tests to monitor blood levels of the medication as it can go toxic and they have to monitor your white blood cell count.

Have you tried Valproate? Aka Divalproex aka Sodium Valproate which go by the trade names Depakote, Epival, Epilem and a thousand others. I know it get's a bad name but it is a anti-convulsant/anti-manic drug like carbamazepine and oxcarbazepine and does work for some people. Most people find it more tolerable then carbamazepine which granted isn't saying much. I never got any side effects from Divalproex but it didn't work for me either so i was only on it a few months. These drugs aren't mood stabilizers they just stop mania they don't help depression at all. Only Lamictal and Lithium are true mood stabilizers as they help both the mania and depression side of things. But seeing as your tapering off Valium Lithium wouldn't really be the way to go right now imo. I went on alot of different meds until i found that Lamictal works the best for me. It took me a long ass time to find the right meds i know that.
 
Depakote and I don't really get along. I need 1500 milligrams a day which is in the toxic zone and I would probably gain 90 pounds from it to boot.

I don't want to be on anything and I don't feel that I have a mood disorder now that I stopped drinking. I'm in the process of sourcing diazepam so I can stop this madness and drop this psychiatrist.
 
MagickalKat777 said:
Depakote and I don't really get along. I need 1500 milligrams a day which is in the toxic zone and I would probably gain 90 pounds from it to boot.

I don't want to be on anything and I don't feel that I have a mood disorder now that I stopped drinking. I'm in the process of sourcing diazepam so I can stop this madness and drop this psychiatrist.
Click to expand...

Hmm i never got any noticeable side effects from Divalproex but about 1000mg's or so is around the top dose i made it to. My shrink figured that if the Epival as it's called here didn't work at that dose to stabilize my mood on top of the seroquel i was already taking then taking more wasn't gonna help. Another reason psychiatrists sometimes prescribe Divalproex during benzo wd is because it apparently does help some peoples withdrawal symptoms and as it's also a pretty strong anti-convulsant so it lower the risk of seizures. But if it's not for you it's not for you and if there is no need for you to be on a mood stabilizer (you can't be diagnosed with a mood disorder or anything properly if you are withdrawing from a benzo anyway) then there's no reason to take the risks associated with these drugs.

Good luck on getting off the things and getting rid of your psychiatrist. I have never had a good experience with a psychiatrist yet to be honest and I've been dealing with them since about 2005.
 
paranoid android said:
Hmm i never got any noticeable side effects from Divalproex but about 1000mg's or so is around the top dose i made it to. My shrink figured that if the Epival as it's called here didn't work at that dose to stabilize my mood on top of the seroquel i was already taking then taking more wasn't gonna help. Another reason psychiatrists sometimes prescribe Divalproex during benzo wd is because it apparently does help some peoples withdrawal symptoms and as it's also a pretty strong anti-convulsant so it lower the risk of seizures. But if it's not for you it's not for you and if there is no need for you to be on a mood stabilizer (you can't be diagnosed with a mood disorder or anything properly if you are withdrawing from a benzo anyway) then there's no reason to take the risks associated with these drugs.

Good luck on getting off the things and getting rid of your psychiatrist. I have never had a good experience with a psychiatrist yet to be honest and I've been dealing with them since about 2005.
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I liked Depakote for the short time I was on it. I suppose I could bring up trying it again. I already know my therapeutic level is 1000mg a day.

The thing is, I don't want to be on something she can test me for.

I figured my shit out though. Won't be needing her for my Valium anymore.

I'm kind of pissed that I had to bump it up to 10mg a day again because of this disaster med though. Man I haven't been that close to full blown withdrawal since that rapid detox where they put me on that 1500mg dose of Depakote last July or August!

I'm gonna have to do a liquid titration to get off this shit doing micro cuts every day instead of this using whole pills and splitting the fuck out of them. If I do that, this whole process will end so much quicker.
 
I take it for seizures. I have a history of non-compliance when I am using, so when I go back to rehab I always get put back on some sort of seizure med regimen and it is usually this med. The second to last time I went to rehab I got back stable on it and the Dr. said "it's good that it is a mood stabilizer as well, because you PROBABLY have some sort of a mood disorder.. most female addicts do." Uhhhhhhhhhhhh... ok. Just ASSUME bro, cool. But whatever, I am taking it because I hate having seizures and actually, I think it probably HAS helped my moods even out a little.

I have not noticed any unpleasant side effects or anything. It has never made me sleepy or anything. I just take it twice a day and feel pretty decent. Only thing is, I am not sure why but they always give me the chewable ones and I usually swallow them but the other day I had nothing to drink and I was too lazy to go get something so I chewed it and it tasted like a bag full of smashed assholes. But other than that, no complaints.

I think it's worth a shot? It isn't the worst med they could put you on, you know?
 
deltakappamu said:
The second to last time I went to rehab I got back stable on it and the Dr. said "it's good that it is a mood stabilizer as well, because you PROBABLY have some sort of a mood disorder.. most female addicts do." Uhhhhhhhhhhhh... ok. Just ASSUME bro, cool.
Click to expand...

That would have made me feel like strangling him TBH. Mood disorder? You want to see a disordered mood, Doctor? Because you have definitely just disordered mine with that sexist crap!
 
All doctors suck. I think I'm going to fire mine and find a new one. I'm required to have a psychiatrist because of disability regardless, I just need to find one that doesn't want to put me on every drug under the sun.

I've taken worse things than carbamazepine for sure but nothing that wiped out my Valium and threw me into withdrawal. With that said, carbamazepine is nowhere near as bad as olanzapine....

And yeah I would have told that doc off.
 
Well Carbamazepine like Phenytoin aka Dilantin, Phenobarbital as well as Primidone which metabolizes into Phenobarbital is a enzyme inducer thus your liver would be spitting out that Valium much quicker then usual. The Valproates are not enzyme inducers however so you don't have to worry about that with Depakote. Funny that you mention Olanzapine as being worse then Carbamazepine because i find that med to be a godsend when it comes to helping my bipolar disorder especially the Manic and mixed states as the Zyprexa Zydis wafers kick in really fast and i get no real side effects except for perhaps some mild drowsiness even if i take 20mg's of Olanzapine in one go which is the maximum dose you can take in a day. However since my stupid insurance only covers the typicals and the only 2 atypicals it covers are seroquel and risperidone i am stuck with shitty seroquel which does not work nearly as well for me. I hate the zombie feeling i get from taking 2mg+ of risperidone.

Everyone reacts differently to these meds so you really can't go by other peoples experiences. Though you can sometimes gauge how much the meds might suck.
 
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