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Decreased Appetite, Anxiety And Vomiting. Taking Klonopin For Anxiety And Lamictal For Bipolar Disorder. Suggestions?
Hello. I frequently wake up feeling extremely anxious and nauseous. This sometimes results in vomiting. My appetite has also decreased steadily over the past few weeks, due in part, I imagine, to having had a tooth extracted (I'm now missing most of my molars). I've never had a huge appetite, but used to get hungry late at night and would usually eat at least one big meal before going to bed (usually around 3 or 4 a.m., as I'm a night owl and always have been). Recently, though, I haven't even felt very hungry at nighttime. I do smoke fairly heavily (about a pack/day) and drink 4-6 alcoholic beverages every night (usu beer, sometimes liquor), and occasionally even more. I'm Bipolar and have battled alcoholism in the past. I was diagnosed last year with a significantly high RBC. I'm not sure how, if at all, all these things tie together. I currently take Klonopin for anxiety, and am supposed to take Lamictal for my Bipolar disorder but ran out of my supply about a month and a half ago. I'm currently working on trying to make an appointment w/ a local psychiatrist so I can get back on them. Being uninsured, I can't afford to see a doctor, and because I live with my parents (who receive Social Security), I don't qualify for Medicaid and can't even afford Obamacare. I turn 34 next month. What advice can you give me, if any? Thanks.
Thu, 14 Nov 2013
welcome to HCM!
I have gone through your question carefully and from my clinical experince I would say that most important thing is that you should try to take treatment and not diccontinue it, as it will only make things worse.
Now coming to your current problems: anxiety, depression, lack of appetite, nausea, you take alcohol and smoke almost regularly.
You have been on lamictal but ran out of supply sometimes back.
From your presentation it looks that you are having an episode of depression right now and have a life time diagnosis of Bipolar. For bipolar you have been on lamictal, but you have not mentioned if you used to keep fine on it or not? had I been treating you I would have gone for sodium valproate for mood stabilization , may be in a dose of 1gm day, at night, plus, some anti depressant right now for some time, eg., paroxetine 25 mg. This combination along with some klonopin 0.5 mg to 1 mg at night should take care of you. For nausea, Omeprazole with domperidone combination, twice. a day, half hour before meals for one to two weeks.
Lamictal is better when patient has more of depressive episodes, or has Recurrent depressive disorder.
I feel that sodium valporate is better in your case as you take alcohol, and smoke also.
One more thing is that, you should definitely cut down on your drinking and smoking. Not only they are bad for health but also reduce the blood levels of drugs which you take making them less effective.
With above said medicines, please do get a blood count, platelets, RBC levels, thyroid levels, liver, lipid and kidney function tests.
It is recommended that one sound get the valporate levels done- 24 hrs post dose, to check if sufficient blood levels have been achieved to bring desired effect.
If possible, when you start feeling better after taking these medicines , please start exercising and take regular meals, this will help in long term improvement.
I would also like to tell you that I have seen cases worse than your getting well, so you need not loose heart, just take one step at a time in right direction and you will start improving.
Hope the reply helps you
feel free to ask more questions
Dr. Manisha Gopal.
I have gone through your question carefully and from my clinical experince I would say that most important thing is that you should try to take treatment and not diccontinue it, as it will only make things worse.
Now coming to your current problems: anxiety, depression, lack of appetite, nausea, you take alcohol and smoke almost regularly.
You have been on lamictal but ran out of supply sometimes back.
From your presentation it looks that you are having an episode of depression right now and have a life time diagnosis of Bipolar. For bipolar you have been on lamictal, but you have not mentioned if you used to keep fine on it or not? had I been treating you I would have gone for sodium valproate for mood stabilization , may be in a dose of 1gm day, at night, plus, some anti depressant right now for some time, eg., paroxetine 25 mg. This combination along with some klonopin 0.5 mg to 1 mg at night should take care of you. For nausea, Omeprazole with domperidone combination, twice. a day, half hour before meals for one to two weeks.
Lamictal is better when patient has more of depressive episodes, or has Recurrent depressive disorder.
I feel that sodium valporate is better in your case as you take alcohol, and smoke also.
One more thing is that, you should definitely cut down on your drinking and smoking. Not only they are bad for health but also reduce the blood levels of drugs which you take making them less effective.
With above said medicines, please do get a blood count, platelets, RBC levels, thyroid levels, liver, lipid and kidney function tests.
It is recommended that one sound get the valporate levels done- 24 hrs post dose, to check if sufficient blood levels have been achieved to bring desired effect.
If possible, when you start feeling better after taking these medicines , please start exercising and take regular meals, this will help in long term improvement.
I would also like to tell you that I have seen cases worse than your getting well, so you need not loose heart, just take one step at a time in right direction and you will start improving.
Hope the reply helps you
feel free to ask more questions
Dr. Manisha Gopal.
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