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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Simcha on December 8, 2002, at 5:38:58
Well folks it's 3:30am. I have not had insomnia this bad in ages. Of course I did drink some coffee after 1pm, this I don't usually do. I slept until 1pm today from last night.
There has been a lot going on. I've been recently diagnosed with asthma. Now I'm on a whole regimen of allergy medication as follows:
60mg Allegra bid or as needed
Flonase, One squirt each nostril
Albuterol, two inhalations every
six hours as neededThis is in addition to my psych meds:
40mg Celexa, am
200mg WellbutrinSR, am
500mg Neurontin at nightWhat the heck? What could be causing this bloody disruption in sleeping patterns?
I'm also less than thrilled that I have doubled the prescriptions that I need to keep track of. I'm so happy that I have insurance yet having to keep track of all of this damn medicine is making me buggy!
I'm only 32 years old and I have six prescriptions. Sheesh, I can't wait to see what 60 years old is like. Will I need like 12 meds? Then I'll have a pill case the size of a car in order to keep track of dosing.
OK, so I'm feeling sorry for myself. I need to get to sleep. Maybe if I lie down I can get some sleep.
Oh yeah, and I need to get my school work done before monday. :-(
Blessings,
Simcha
Posted by Dinah on December 8, 2002, at 9:05:43
In reply to Can't Sleep Normally -- New Meds?, posted by Simcha on December 8, 2002, at 5:38:58
Hi Simcha,
I don't know about your asthma medicines, but Wellbutrin is extremely activating, and the only SSRI I took messed up my sleep a bit.
Perhaps the 500 mg Neurontin isn't enough to tackle all that. I could be wrong about this, but from what I recall from the board, a lot of people seem to get used to the Neurontin and have to raise the dose.
How long have the insomnia problems been around?
Dinah
Posted by medlib on December 8, 2002, at 23:09:08
In reply to Can't Sleep Normally -- New Meds?, posted by Simcha on December 8, 2002, at 5:38:58
Hi Simcha--
Yeah, taking 6 drugs is a logistical hassle, and the chances for drug interactions rise with the number of meds involved.
2 of your psych meds can cause insomnia: Wellbutrin does in over 40% of those taking 300 mg. XL. Celexa can cause insomnia in some, drowsiness in others; *and* it can cause respiratory problems--coughing, frequently; asthma, rarely. Neurontin is not metabolized in the body at all; it is excreted in the urine unchanged.
You're not taking a lot of Flonase, but it *can* interact with Celexa. Flonase inhibits the liver enzyme CYP3A4, which is one of the 2 which metabolize (break down) Celexa. The result is that Celexa can stay in the bloodstream longer and its effect may be stronger.
You may want to consider switching the Celexa to a different SSRI. Even better, the doc who prescribed your asthma meds should talk to your pdoc; maybe, both need to talk to a pharmacist.
I get a little annoyed when no one will take responsibility for the whole patient. I *don't* have medical insurance, and I'm likely not to pay a doc who won't take the time to read his PDR or consult an Internet drug database. I most certainly will not go back. End of rant (for now).
Take care (and a pinch of paranoia re meds wouldn't hurt)---medlib
Posted by AllieD on December 9, 2002, at 19:36:11
In reply to Can't Sleep Normally -- New Meds?, posted by Simcha on December 8, 2002, at 5:38:58
> Albuterol, two inhalations every
> six hours as neededYeah, there's a lot of medications there, but this jumped out at me -- albuterol (similarly to other asthma medications) can be extremely stimulating. I know I'm especially sensitive -- anytime I've gotten an albuterol "treatment" in the hospital, where they basically pump a whole lot of the medicine into you, I get *extremely* nervous and shaky. (Nurses and doctors helpfully comment "I've never seen someone react so strongly!") I take lorazepam to counter the effect, but I know that's not a good habit. Luckily my asthma is no longer that bad, but since my anxiety is through the roof, I try to avoid using asthma medicines as much as possible (do this at your own risk!).
Best,
Allie
PS: I wish I took only 6 medicines a day.. and I'm only 22. :)
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