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Does Intake Of Promethazine Cause Mood Swings?

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Posted on Mon, 20 Jun 2016
Question: Hi XXXXXXX here. As you know I have recently started on Promethazine 1 tablet twice a day. Every day within the past week in the afternoon, I have had to report to my partner that my mood has dramatically dipped. On a scale of 1-10 mood scale, my mood has been about 3 lowest? Is it possible that the Promethazine is kicking in, but it is making me feel worse before it starts making me feel better? I am quite concerned, should I be?
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Answered by Dr. Alexander H. Sheppe (6 hours later)
Brief Answer:
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Detailed Answer:
Hello XXXXXXX It's great to hear from you again. I'm sorry you are experiencing this dip in your mood -- let me give you my thoughts.

Promethazine as you know is a first generation neuroleptic, and it is being used in your case to help stabilize mood. Because it functions as a mood stabilizer and consequently an antidepressant, it is unlikely that promethazine is causing depressed mood directly. What I would guess instead is that this is most likely your body "getting used to" the medication. Your brain receptors are changing to adjust to the medication, which is a temporary situation as the medicine builds to therapeutic and stable levels in the body. I would guess that in the afternoon you get a dip of fatigue, and as we know promethazine can certainly worsen fatigue and cause sleepiness while your body adjusts to it. So I would venture that a combination of fatigue and bodily adjustment is what is causing your current experience. I would anticipate these side effects going away within 1-2 weeks. If they aren't, you could always consider a different medication. But I think with time this will resolve and the medication will begin working for you as intended.

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Alexander H. Sheppe (16 hours later)
Hi XXXXXXX here again. I have just read something that suggests Promethazine is an anti psychotic medication, is this true.

Also, wanted to inform you that I have had a meeting with a mental health advocate. She is planning to speak to one of the doctors at the surgery, Mindincambs (the mental health XXXXXXX I have just finished working with, and CPFT. She is planning on going to a surgery appointment with me. She is also planning to set me up working with a mental health support worker. Could I possibly keep you updated with everything she is planning on doing with me/on my behalf including the mental health support worker?
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Answered by Dr. Alexander H. Sheppe (5 hours later)
Brief Answer:
Private Followup

Detailed Answer:
Yes, it is true that promethazine was ORIGINALLY developed as an antipsychotic medication. However, it is also very effective and FDA approved for other uses, including as a mood stabilizer, an antidepressant, an anti-manic agent, and helps with impulse control. So it is a widely used and very versatile medication used to help people with many things.

Of course, I would love for you to keep me updated about any developments or planning for the future. I am always available on this website for any question, comment, or help you may have or need. It would be my pleasure.

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Alexander H. Sheppe (3 days later)
Hi XXXXXXX here. I took my Promethazine at 10.30 last night, and I didn't get to sleep till 3am. I have been on the medication for about 3 weeks now. Is insomnia a common side effect? If yes, what should I do from here?
doctor
Answered by Dr. Alexander H. Sheppe (1 hour later)
Brief Answer:
Private Followup

Detailed Answer:
Hi XXXXXXX Promethazine is actually typically a sedating medication, which means typically it actually helps people sleep. A strategy I would try would be to switch more of your dosage to the evening dose rather than the morning dose. By increasing the evening dose, that may help you sleep better.

Dr. Sheppe
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

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Does Intake Of Promethazine Cause Mood Swings?

Brief Answer: Private Consultation Detailed Answer: Hello XXXXXXX It's great to hear from you again. I'm sorry you are experiencing this dip in your mood -- let me give you my thoughts. Promethazine as you know is a first generation neuroleptic, and it is being used in your case to help stabilize mood. Because it functions as a mood stabilizer and consequently an antidepressant, it is unlikely that promethazine is causing depressed mood directly. What I would guess instead is that this is most likely your body "getting used to" the medication. Your brain receptors are changing to adjust to the medication, which is a temporary situation as the medicine builds to therapeutic and stable levels in the body. I would guess that in the afternoon you get a dip of fatigue, and as we know promethazine can certainly worsen fatigue and cause sleepiness while your body adjusts to it. So I would venture that a combination of fatigue and bodily adjustment is what is causing your current experience. I would anticipate these side effects going away within 1-2 weeks. If they aren't, you could always consider a different medication. But I think with time this will resolve and the medication will begin working for you as intended. Dr. Sheppe