Cymbalta Withdrawal Forums + Bruxism

While I was doing research for my latest medication profile, I stumbled upon cymbaltawithdrawal.com, a website started by someone who presumably went through the trials of Cymbalta withdrawal and the associated SSRI/SNRI discontinuation syndrome. It’s an open forum for other people who are going through the same experience, and people are free to discuss what’s going on for them during the withdrawal period. This website is a bit of a grim view into the future for me; if Cymbalta turns out to be just like all the other drugs I’ve tried (failures), then one day I’ll have to stop taking it and will probably suffer from the discontinuation syndrome. However, my pharmacist told me that Cymbalta withdrawal is apparently not as bad as Effexor (Venlafaxine) withdrawal, which I have also been through. If she’s right, then I think I should be able to manage.

Bruxism. Bruxism started becoming an issue for me about two months ago. I first started noticing jaw pain during the day, as though my mouth was constantly working throughout the night. Also when my mother came to check on me, she could hear my jaw creaking while I was asleep. Then I started to notice jaw clenching and tooth grinding during the day – first only a little bit, then more and more until I was constantly clenching unless I made a concerted effort not to. Even then, I would only last about three to five seconds before my jaw would clench again. As a result of all this clenching, I get a lot of pain in my jaw, and I assume I’m doing damage to my teeth, but I haven’t seen a dentist in years. That’s on my list of things to do. I already take the dietary supplements recommended for people with bruxism – Pantothenic Acid, Magnesium, and Calcium – but they don’t appear to be helping.

There are a number of things that could be contributing to my bruxism:

• Smoking
• Anorexia Nervosa
• Insomnia
• Consumption of caffeine
• High levels of stress and anxiety
• Cymbalta (Duloxetine)
• Dexedrine (Dextroamphetamine)
• Obsessive-Compulsive Disorder
• Generalized Anxiety Disorder

Any or all of those things could be impacting upon my bruxism, but it’s nigh impossible to tell exactly which one it is. On a hunch, my psychiatrist advised me to lower my dose of Dexedrine to see if that would affect the bruxism, but even after a week of being Dexedrine-free I was still bruxing heavily. To keep from grinding my teeth all day long, I try to bite my lip or tongue when I notice I’m bruxing, but I feel like it makes me look sort of funny. Some people, including my mother, a friend, and my psychiatrist, have mentioned that I visibly appear to be chewing or otherwise moving my jaw around constantly whenever I’m not speaking. It makes me very self-conscious about being out in public.

I’ve heard about people using benzodiazepines to relieve bruxism, but I’m not too keen on going back to those if I can help it. I don’t think my psychiatrist would be down for that either. Another totally extreme option is Botox – actually freezing the muscles that are doing the bruxing – but there’s no way I’m going to willingly allow someone to paralyze parts of my face.

And So Begins the Cymbalta Trial…

As I had discussed previously with my psychiatrist, we decided on Wednesday to put me on Cymbalta (Duloxetine). I took my first dose Wednesday night so that means I’m on my second full day of being on it. As with other SSRI/SNRI medications, it takes at least a week, but usually 2 – 4 weeks, to see any change. I think I’ve said this before but it bears repeating: I have little faith that Cymbalta is going to do anything for me. I think I just have a general tolerance to medications that work with serotonin, and perhaps norepinephrine. Maybe not norepinephrine, though; I did see a small (barely discernible, but apparent to the trained observer) change in my mood while I was on Effexor (Venlafaxine), which is an SNRI, so maybe I do respond a bit to norepinephrine inhibitors. Anyway the current plan is to take 30mg at night for two weeks, and then raise the dose to 60mg. My psychiatrist is prepared to go to 90mg if we don’t see any results after 3 weeks on 60mg.

Another thing we discussed on Wednesday was adjunct treatments; I’d been doing my usual research and had come across the name Abilify (Aripiprazole), an atypical antipsychotic that is also approved for treatment of Bipolar II and has recently been approved as an adjunct treatment for depression when used with another antidepressant. Abilify is specifically for people like me who haven’t seen any (or enough) effects from taking only one antidepressant. I’m not sure exactly how it works, but it sounds tempting. Another possible plus of Abilify would be that, as an antipsychotic, it may act like Risperidal (Risperidone) and control my verbal and motor tics, which would enable me to cut that medication out of my schedule. Cons of Abilify are:

- I would be taking yet another medication.
- It can cause insomnia, which would worsen an already horrible situation.
- It can cause shaking/tremors, which would make me even shakier.
- It can cause high blood sugar, and some people have developed diabetes while taking it (note that this was after long-time use – several years).
- It can cause speech disorders, which would complicate things because I already talk strangely because of my bruxism.
- It can cause permanent tardive dyskinesia. However, I’ve already been on Risperidone for about a year and a half and I haven’t developed this symptom. That said, though, I’m not sure what the risk factor is for Abilify in relation to Risperidone.

So there are, in fact, quite a few reasons why I shouldn’t go on Abilify. It seems, just from the readings I’ve done, to be more risky and potentially side effect-y than Risperidone. But it might be a valuable tool as an adjunct treatment – a lot of people are reporting great successes with it. I really wouldn’t want to miss out if there was a chance that this medication could help me.

The last thing I discussed with my psychiatrist was my anxiety. Due to certain environmental factors in my life at the moment and in the past few weeks, I’ve been a lot more anxious (in certain situations) than usual, but I also feel like my base level of anxiety has risen. I’m anxious about some things that are typical of people with anxiety disorders – social situations, public places, taking transit, the police/authority figures, etc., but I’m also anxious about other things, like getting out of bed. This anxiety is seriously keeping me from getting things done because it totally shuts me down and renders me unable to make effective decisions. Given all that, I decided it was time to ask my doctor about trying anxiolytic medication again. He’s really not a fan of benzodiazepines in the first place, and especially not in my situation, so he ignored them altogether and considered some other options. He ended up deciding that if the Cymbalta doesn’t have any anti-anxiety effect on me in 5 weeks, he’ll start me on a trial of Buspar (Buspirone). I’ve been on Buspar once before but the results were inconclusive. I don’t think we gave it enough time or a high enough dose to really see what it could do for me.

Anyway, here’s an idea of what my current meds look like. There’s some new additions in both the prescription and non-prescription categories.

Cymbalta (Duloxetine): 30mg nightly – for Depression
Imovane/Immovane (Rhovane) (Zopiclone): 22.5mg nightly – for Insomnia
Risperidal (Risperidone): 2.5mg nightly – for Tourrette Syndrome
L-Tryptophan: 1000mg nightly – for Insomnia
Dexedrine (Dextroamphetamine) Spansules: 40mg in the morning as needed – for Depression-related symptoms
Chloral Hydrate: 10mL nightly – for Insomnia

Clindoxyl (Clindamycin and Benzoyl Peroxide): apply topically at night – for acne
Delatestryl (Testosterone Enanthate): 60mg intramuscular once weekly (Friday) – for low testosterone
Erythromycin: 333mg in the morning and at dinnertime – for acne
Losec (Omeprazole): 20mg in the morning (before eating) – for acid reflux
Fucidin (Fusidic Acid): apply topically once daily – for Impetigo

Melatonin: 3mg nightly – for Insomnia
Multivitamin: 1 in the morning – for overall health
Salmon Oil: 1 in the morning, at dinnertime and at night – for high cholesterol
Vitamin C:  500mg in the morning – for overall health
Calcium + Vitamin D: 500mg Calcium and 125IU Vitamin D (1 tablet) in the morning and at night – for bone health
Valerian Root: 800mg (2 tablets) nightly – for Insomnia and Generalized Anxiety Disorder
“Stress Relief” B50 Complex with Sensoril: 1 capsule nightly – for anxiety
Siberian Ginseng: 250mg (1 tablet) in the morning, at dinnertime and at night – for stress and low energy
“Relaxing Night” herbal tea*: 1 bag steeped in hot water nightly – for Insomnia

* “Relaxing Night” tea contains Chinese jujube, subterranean fungus, white mulberry, lycium barbarum, and Chinese yam.

Venlafaxine Taper + Current Medications

So over the past few weeks I haven’t posted anything. That is mostly due to some personal turmoil and arguments with and about the healthcare system here in Canada. I won’t delve into it too much here, but I’ll say that it’s incredibly difficult to get admitted anywhere when you present with multiple psychiatric diagnoses. The leading psychiatric hospital’s emergency room in my city wouldn’t take me because my eating disorder is too severe, but they also told me that they doubted that I was physically ill enough to warrant admission to a general hospital. That leaves me falling through the cracks. Thanks so much, healthcare system.

Another thing that’s been going on over the past month is that I’m slowly tapering off of Effexor (Venlafaxine). I was told by several sources how difficult some people find it to taper off this medication, but I didn’t have a terrible time. It wasn’t easy, though. I got the “brain zaps”, nausea, vomiting, a lot of dizziness, and my shakes became more pronounced. Things have calmed down a lot in the past few weeks.

Ever searching for something to help my insomnia, I tried Valerian Root - my psychiatrist recommended it. Once you get over the fact that it smells like hot vomit, it’s okay. I think it’s helped a tiny bit. I ran clean out of Chloral Hydrate, Imovane (Rhovane) (Zopiclone), and Risperidal (Risperidone) for a few days, which obviously made it a lot harder for me to sleep. I think I got a total of two hours over the course of four nights. It was intense. Luckily the doctor in emergency prescribed me enough of those medications to last me until I see my GP (tomorrow) and she’ll get me back on track, prescription-wise.

On the theme of sleep medications, I forgot to bring up something important with my psychiatrist yesterday: I have developed a tolerance to the dose of sleeping medication that I’m on at the moment. This means I’ll have to have another increase in order to get some good sleep. I’m going to call him today about that. I’m also going to see if he’ll refer me to the psychiatric hospital in the city – maybe if I skip the emergency room and get another doctor to review my case, they’ll admit me. It’s worth a try!

So here’s what my pill chart looks like:

Effexor (Venlafaxine): 37.5mg in the morning – reducing by 37.5mg each week until discontinued – for Depression
Imovane/Immovane (Rhovane) (Zopiclone): 22.5mg nightly – for Insomnia
Risperidal (Risperidone): 2.5mg nightly – for Tourrette Syndrome
L-Tryptophan: 1000mg nightly – for Insomnia
Dexedrine (Dextroamphetamine) Spansules: 40mg in the morning as needed – for Depression-related symptoms
Chloral Hydrate: 10mL nightly – for Insomnia

Clindoxyl (Clindamycin and Benzoyl Peroxide): apply topically at night – for acne
Delatestryl (Testosterone Enanthate): 60mg intramuscular once weekly (Friday) – for low testosterone
Erythromycin: 333mg in the morning and at dinnertime – for acne
Losec (Omeprazole): 20mg in the morning (before eating) – for acid reflux
Fucidin (Fusidic Acid): apply topically once daily – for Impetigo

Melatonin: 3mg nightly – for Insomnia
Multivitamin: 1 in the morning – for overall health
Salmon Oil: 1 in the morning, at dinnertime and at night – for high cholesterol
Vitamin C:  500mg in the morning – for overall health
Calcium + Vitamin D: 500mg Calcium and 125IU Vitamin D (1 tablet) in the morning and at night – for bone health
Valerian Root: 800mg (2 tablets) nightly – for Insomnia and Generalized Anxiety Disorder
“Relaxing Night” herbal tea*: 1 bag steeped in hot water nightly – for Insomnia

* “Relaxing Night” tea contains Chinese jujube, subterranean fungus, white mulberry, lycium barbarum, and Chinese yam.

[More] Current Medication List

At my last visit with my psychiatrist we decided that the Effexor (Venlafaxine) isn’t doing anything for me; therefore we decided to start tapering me off it in preparation to go on another medication. We’re not sure yet what that new med will be, but my shrink is thinking of Cymbalta (Duloxetine). I’m not sure what I think of sticking with an SNRI (Serotonin-Norepinephrine Reuptake Inhibitor) – I already know I have a tolerance to SNRI medications, as evidenced by my experiences with Effexor. I’m more of the opinion that we should switch to a TCA (Tricyclic Antidepressant) or an MAOI (Monoamine Oxidase Inhibitor). Then again, I’m not a doctor

Effexor (Venlafaxine): 112.5mg in the morning – reducing by 37.5mg each week until discontinued – for Depression
Imovane/Immovane (Rhovane) (Zopiclone): 22.5mg nightly – for Insomnia
Risperidal (Risperidone): 2.5mg nightly – for Tourrette Syndrome
L-Tryptophan: 1000mg nightly – for Insomnia
Dexedrine (Dextroamphetamine) Spansules: 40mg in the morning as needed – for Depression-related symptoms
Chloral Hydrate: 10mL nightly – for Insomnia

Clindoxyl (Clindamycin and Benzoyl Peroxide): apply topically at night – for acne
Delatestryl (Testosterone Enanthate): 60mg intramuscular once weekly (Friday) – for low testosterone
Erythromycin: 333mg in the morning and at dinnertime – for acne
Losec (Omeprazole): 20mg in the morning (before eating) – for acid reflux

Melatonin: 3mg nightly – for Insomnia
Multivitamin: 1 in the morning – for overall health
Salmon Oil: 1000mg in the morning, at dinnertime and at night – for high cholesterol
Vitamin C:  500mg in the morning – for overall health
Calcium + Vitamin D: 500mg Calcium and 125IU Vitamin D in the morning and at night – for bone health

Current Medication List

I’ve been having a lot of issues with sleep lately so my last visit mostly dealt with that. I brought up the idea of using Chloral Hydrate again – I haven’t been on it in probably about a year and a half. We started me off at a dose of 10mL and decided to see what that would do to me. So far I’m sleeping a lot better, but I know eventually I’m going to build up a tolerance to the Chloral Hydrate and I’ll have to increase my dose. Hopefully that won’t be for a while though.

Effexor (Venlafaxine): 187.5mg – 37.5mg in the morning and 150mg at noon – for Depression
Imovane/Immovane (Rhovane) (Zopiclone): 22.5mg nightly – for Insomnia
Risperidal (Risperidone): 2.5mg nightly – for Tourrette Syndrome
L-Tryptophan: 1000mg nightly – for Insomnia
Dexedrine (Dextroamphetamine) Spansules: 40mg in the morning as needed – for Depression-related symptoms
Chloral Hydrate: 10mL nightly – for Insomnia

Clindoxyl (Clindamycin and Benzoyl Peroxide): apply topically at night – for acne
Delatestryl (Testosterone Enanthate): 60mg intramuscular once weekly (Friday) – for low testosterone
Erythromycin: 333mg in the morning and at dinnertime – for acne
Losec (Omeprazole): 20mg in the morning (before eating) – for acid reflux

Melatonin: 3mg nightly – for Insomnia
Multivitamin: 1 in the morning – for overall health
Salmon Oil: 1000mg in the morning, at dinnertime and at night – for high cholesterol
Vitamin C:  500mg in the morning – for overall health
Calcium + Vitamin D: 500mg Calcium and 125IU Vitamin D in the morning and at night – for bone health

Even More Most Common Search Responses

Search keywords: Is Rhovane addictive
The short answer is yes, Rhovane (Imovane) (Zopiclone) can be addictive. For more information, please see my previous posts on how to stop taking Rhovane, side effects of quitting Rhovane all at once, and Rhovane addiction.

Search keywords: Dexamphetamine Clonazepam
Dextroamphetamine does not appear to have any interactions with Clonazepam. However, if Dextroamphetamine is being used to treat depression, it must be noted that the two medications will act essentially as polar opposites: in the depressed, Dextroamphetamine increases (among other things) energy, alertness and concentration, while Clonazepam is used as a sedative and sometimes as a sleep aid. 

Search keywords: Rhovane dosage
Dosage of Rhovane (Imovane) (Zopiclone) varies on an individual basis and is dependent upon criteria such as individual tolerance, desired effects, and tolerance to side effects. That said, many clinicians start their patients at a dose of 7.5mg and stop at a maximum of 15mg or 22.5mg. Your doctor may follow different guidelines.

Search keywords: Can I take Serequel (Seroquel) and Immovane (Imovane) together
Seroquel and Imovane don’t appear to interact with each other, but together they may have a potent sedating effect.

Search keywords: Can you inject shoot Imovane Zopiclone
Zopiclone can be injected intravenously. Medicatedboy does not endorse the misuse of prescription drugs – that is, using prescription medication in any way or amount not specifically stated in the prescribing information.

Search keywords: Can Imovane cause nervousness
“Mood or mental changes” are listed as possible side effects of Imovane. Whether or not that includes nervousness is unclear, but it’s entirely possible.

Search keywords: Zopiclone Quetiapine Citalopram
As already stated, Zopiclone and Quetiapine (Seroquel) (Quetiapine Fumarate) do not appear to interact with each other; neither do Zopiclone and Citalopram. Finally, Quetiapine and Citalopram do not appear to have any interactions, but caution is recommended when taking more than one CNS (central nervous system) active medication.

Search keywords: Is Rhovane available in the United States
Rhovane (Imovane) (Zopiclone) is not commercially available in the United States.

Search keywords: Imovane SSRI
It doesn’t look like Imovane (Rhovane) (Zopiclone) interacts with SSRI medications.

Search keywords: Zopiclone Methylphenidate
Zopiclone (Imovane) (Rhovane) doesn’t interact with Methylphenidate (Ritalin), but as with Dextroamphetamine and Clonazepam (discussed above), the two medications have essentially reverse effects in depressed patients: Zopiclone induces sleep, while Methylphenidate provides some depressed patients with more energy, concentration and alertness.

Search keywords: Can I take Omeprazole with Levothyroxine
Please see my post entitled “Omeprazole and Levothyroxine at the same time” for more information.

Search keywords: Eltroxin and vitamin supplements
I covered this in a previous entry – feel free to take a look.

Search keywords: Melatonin Prozac concurrently
From umm.edu: “In an animal study, melatonin supplements reduced the antidepressant effects of desipramine and fluoxetine. More research is needed to determine whether these effects would occur in people. In addition, fluoxetine (a member of a class of drugs called selective serotonin reuptake inhibitors, or SSRIs) has led to measurable depletion of melatonin in people.”

Search keywords: Sertraline and Levothyroxine
People who take Levothyroxine and Sertraline together may need more Levothyroxine to experience therapeutic effects.

Search keywords: Citalopram and Zopiclone side effects together
Citalopram isn’t listed as interacting with Zopiclone, but the actions of Citalopram haven’t been super-extensively researched in clinical trials, so there could be an interaction present that hasn’t been detected yet.

Note: I am not a doctor, and the information I state on my blog is gathered from internet sources and physician’s handbooks. Therefore, it is important to speak to your doctor if you are unclear about something or if you have more questions that I am not qualified to answer.

More Most Common Search Responses

Search keywords: Take Omeprazole with Multivitamin
Taking Omeprazole at the same time as a Multivitamin is probably a good thing – Losec (Omeprazole) may reduce or interfere with the function or absorption of certain vitamins, so taking a supplement is not a bad idea. Taking the two at the same time will not provoke any negative side effects.

Search keywords: Imovane 22.5mg one dose
22.5 mg, or three pills of Imovane (Rhovane) (Zopiclone) is a moderate to heavy dose that may be needed by people who have a high natural tolerance or who have been taking Imovane for an extended period of time (and have therefore developed a tolerance). It is not recommended to stay on Imovane for a period longer than four (4) weeks at a time.

Search keywords: Side effects of quitting Rhovane all at once
Depending on how long you have been taking Rhovane (Imovane) (Zopiclone) and what dose you were taking, you may have developed a physical dependence on it. In this case, stopping Rhovane treatment altogether may produce withdrawal symptoms, which can include anxiety, tachycardia, tremor, sweats, flushes, palpitations, derealisation, and rebound insomnia. If these symptoms are unbearable, you may want to consider tapering slowly off of this medication or switching to an equivalent dose of Valium, which can be tapered even more slowly.

Search keywords: Imovane vs Rhovane
Imovane and Rhovane are both brand names for the same medication – Zopiclone. For more information on Zopiclone, please see the Medication Profile that I will be posting shortly.

Search keywords: Scalp odor dexamphetamine
Scalp odor is not a recorded side effect of Dextroamphetamine, but this could be a rare side effect that just hasn’t been recorded yet.

Search keywords: Melatonin and Risperidone in combination
Please see my post entitled “Can you take Melatonin with Risperidone” found here.

Search keywords: Can I take Melatonin and Zopiclone at the same time
Please see my post entitled “Melatonin and Zopiclone used together” found here.

Search keywords: Eltroxin versus antidepressant
Eltroxin is a thyroid medication that is generally used in patients who have low levels of thyroid hormone. Some doctors prescribe it to patients who suffer from treatment-resistant depression as a boost in thyroid may provide extra energy and alertness. Eltroxin is not proven to relieve all symptoms of depression and is not specifically indicated for use in depressed individuals. It is most often used in addition to anti-depressant therapy, as an adjunct medication.

Search keywords: Rhovane addiction
It is possible to become addicted to Rhovane (Imovane) (Zopiclone), both physically and psychologically. You may be addicted to Rhovane if you cannot sleep without taking it, or if you go through withdrawal symptoms if you don’t take your regularly scheduled dose (see more information about Rhovane withdrawal here, under “Rhovane withdrawal”).

Search keywords: Small Adam’s Apple testosterone deficit
Having a small Adam’s Apple is not necessarily a sign of testosterone deficit – you could just be born that way. Some people have body parts or features that are bigger or smaller than others, and it doesn’t always signal that there’s something wrong with you.

Search keywords: Omeprazole and Levothyroxine at the same time
From my research, it looks like people who take Omeprazole and Levothyroxine at the same time may require a higher dose of Levothyroxine to see benefits from taking it. One source states that the dose of Levothyroxine should be about 25% more than the original dose.

Search keywords: Maximum dosing for Rhovane
The maximum recommended dose for Rhovane is 15mg, but many doctors prescribe amounts over the maximum, especially to people with treatment-resistant insomnia or those who have developed a tolerance to this medication. Follow the instructions that your prescribing doctor gives you, and never take more than the amount prescribed to you in any 24 hour period.

Search keywords: Can I take Vitamin D and Calcium with Eltroxin
Please see my previous post entitled “Eltroxin and vitamins”, found here.

Medication Profile: Dexedrine (Dextroamphetamine)

Brand name(s): Dexedrine, Dextrostat, Dexedrine Spansule, Dexedrine SR.

Generic name(s): Dextroamphetamine.

Street name(s), if any: Dexies, Uppers, Bennies, Beans, Black Beauties, Pep Pills.

Available form(s): Tablets.

Available dose(s): Dexedrine: 5 and 10mg. Dexedrine Spansule: 5, 10 and 15mg.

North American availability: Available in both the US and Canada.

Class(es): Psychostimulant.

Method(s) of action: Dextroamphetamine works by increasing dopamine release in the brain.

Most commonly prescribed for: ADHD (Attention Deficit Hyperactivity Disorder) and Narcolepsy.

Also prescribed for: Treatment-resistant depression and obesity, post-stroke physiotherapy, and fatigue in HIV patients.

Possible side effect(s): anorexia, hyperactivity, dilated pupils, flushing, restlessness, dry mouth, bruxism, headache, tachycardia, bradycardia, tachypnea, hypertension, hypotension, fever, diaphoresis, diarrhea, constipation, blurred vision, aphasia, dizziness, twitches, insomnia, numbness, palpitations, arrhythmias, tremors, dry/itchy skin, acne, pallor, convulsions, coma, heart attack, stroke, death, euphoria, increased anxiety, changes to libido, increased alertness, increased concentration, increased energy, increased self-esteem/self-confidence, exhilaration, excitement, increased orgasmic intensity, sociability or social isolation, increased irritability/aggression, psychomotor agitation, hubris, feelings of power/superiority, repetitive/obsessive behaviours, paranoia, amphetamine psychosis, elevation of blood pressure, cardiomyopathy, dryness of the mouth, unpleasant taste, utricaria, impotence.

Possibility of tolerance: Quite possible (dependent on dose and length of treatment).

Addictive potential: Moderate to strong (dependent on dose and length of treatment).

Withdrawal potential: Moderate to strong (dependent on dose and length of treatment).

Withdrawal symptoms: Mental fatigue/depression, increased appetite, agitation, excessive sleep, vivid or lucid dreams, suicidal thoughts, psychosis.

Potential for abuse/misuse: Strong.

Drug interaction(s): Gastrointestinal acidifying agents, urinary acidifying agents, adrenergic blockers, gastrointestinal alkalizing agents, tricyclic antidepressants, MAOIs, antihistamines, Chlorpromazine, Ethosuximide, Haloperidol, Lithium, Meperidine, Methenamine, Norepinephrine, Phenobarbital, Phenytoin, Propoxyphene, Veratrum Alkaloids.

Contraindication(s): Dexedrine should not be used by people who have been or are at an elevated risk of drug or alcohol dependence or addiction, or people who are taking or have taken MAOIs within the last 14 days. It should not be used by people suffering from arteriosclerosis, symptomatic cardiovascular disease, moderate to severe hypertension, hyperthyroidism, known hypersensitivity or idiosyncrasy to the sympathomimetic amines, glaucoma, or a particularly agitated state.

Overdose threshold: Unknown (toxic results can appear at just 2mg, while in other patients doses of 400mg or more are not sufficient to provoke overdose).

Symptoms of overdose: Restlessness, tremor, hyperreflexia, tachypnea, confusion, aggressiveness, hallucinations, panic, rhabdomyolsis, rapid respiration, hyperpyrexia, fatigue, depression, arrhythmias, hypertension, hypotension, nausea, vomiting, diarrhea, abdominal cramps, convulsions, coma, death.

Most Common Search Responses Continued

Search keywords: How Strattera makes you feel in the morning
Strattera (Atomoxetine) is a stimulant medication that is usually taken in the morning. It can be taken for a variety of reasons, but it is most commonly prescribed for people suffering from ADHD (Attention Deficit Hyperactivity Disorder). After you take Strattera, you may feel nauseous, less hungry, dizzy, constipated, or sweaty. You may feel heart palpitations or pain when urinating. Your heart rate and blood pressure may rise. These are all common side effects, but if they bother you or become extreme, be sure to contact your doctor.

Search keywords: Vitamin C and Methylphenidate
A quick search of “Vitamin C and Methylphenidate” brings up no mention of interactions between the two drugs. They are likely safe to take together.

Search keywords: Zopiclone and Strattera
Imovane (Rhovane) (Zopiclone) is a medication commonly used to treat insomnia. Strattera, as described above, is a stimulant most commonly used in the treatment of ADHD. Zopiclone and Strattera should not be taken at the same time, because they are in essence polar opposites of each other. Zopiclone is generally taken at bedtime, and Strattera is taken in the morning, or in the morning and afternoon. There are no recorded interactions between the two medications.

Search keywords: Is it okay to take 2mg Melatonin in 7 hrs
It is safe to take 2mg of Melatonin in 7 hours, but studies have shown that smaller doses of Melatonin are actually more effective – for example, 1mg may actually have a more desirable effect on you than 2 or 3mg.

Search keywords: Dextroamphetamine Ibuprofen
A database search of Dexedrine (Dextroamphetamine) and Ibuprofen together reveals that there are no recorded interactions between the two. They should be safe to take in unison.

Search keywords: Strattera og Ibuprofen
…? og? Next…

Search keywords: Taper off Levothyroxine
Yes, you should taper yourself off of Eltroxin (Levothyroxine). How quickly you do this depends on what dose you have been taking. Ask your doctor for more information about tapering off of Levothyroxine.

Search keywords: HRT reverse skin
The effects that HRT (Hormone Replacement Therapy) has on your skin are different depending on which hormones you are taking.
For people taking feminizing hormones (estrogen, progestin), your skin may become softer, clearer, and smoother.
People taking masculinizing hormones (testosterone, dihydrotestosterone) such as Delatestryl (Testosterone Enanthate), your skin may become rougher to the touch, thicker, and you may develop acne.
The effects caused by both sets of hormones are reversible. If you stop taking the hormones, they will eventually go back to what they were like before.

Search keywords: Calcium Ritalin anxiety
There are no recorded incidences of Ritalin in combination with Calcium causing anxiety. However, it should be noted that a fairly common side effect of Ritalin on its own is anxiety. It is unclear whether adding Calcium to your regimen increases anxiety or adds to the risk of developing anxiety.

Search keywords: Melatonin and Zopiclone used together
There are no interactions between Melatonin and Zopiclone; the two medications are safe to take together. Taking Melatonin and Imovane (Rhovane) (Zopiclone) together may increase your chances of having a restful night’s sleep; both medications have a sedating effect that promotes sleep. As stated above, a study has shown that it may be more effective to take smaller doses of Melatonin (e.g. 1mg) rather than bulking up on it.

Search keywords: Omeprazole light sensitive
I’ll cover two factors in this section: Human sensitivity and drug sensitivity.
One site (http://www.patient.co.uk/medicine/Omeprazole.htm) lists sensitivity to light as a possible side effect of taking Omeprazole. It was not listed on other databases I searched.
The medication itself (e.g. in pill or capsule format) is sensitive to light and should be kept out of direct light in a shaded place, for example in a cabinet or drawer.

Search keywords: Dexedrine doesn’t work for me
Dexedrine (Dextroamphetamine) doesn’t work for everyone. You could have a natural tolerance to stimulant medications, or you just didn’t get a high enough dose. Explore other options, such as Ritalin (Methylphenidate) or Strattera (Atomoxetine) before you give up on stimulant medications. Check with your doctor to find out the highest dose you can go on for each medication.

Search keywords: Effexor Melatonin medicated boy
Oh, someone searched for me! How sweet. And now, back to business. Effexor and Melatonin are safe to take together. However, some people prefer to take Effexor in the morning rather than in the evening. That’s just a matter of personal preference/doctor’s instructions.

Search keywords: Sertraline, Melatonin, Minocycline and
…And what? Seems you got cut off. Anyway, I’ll deal with the other three. Melatonin does have an interaction with some anti-depressant drugs (specifically Norpramin (Desipramine) and Prozac (Fluoxetine)), but not with Sertraline. There is no information on possible interactions between Melatonin and Minocycline. Sertraline and Minocycline also don’t have any recorded interactions.

Search keywords: Could you drink alcohol while taking Eltroxin
You can drink alcohol while taking Eltroxin, but it is likely to impair the mechanism by which the medication works in your system. You may experience less or no benefit from it if you consistently drink alcohol while taking this treatment.

Search keywords: Venlafaxine and Vitamin D
There are no recorded incidences of Venlafaxine interacting negatively with Vitamin D. These medications should be safe to take together.

Search keywords: Strattera Melatonin
According to a database search, there are no interactions between Strattera (Atomoxetine) and Melatonin. The two medications should be safe to take together.

Search keywords: “Acid reflux” Sertraline
Zoloft (Sertraline) is not proven to cause acid reflux, or to have acid reflux as a known side effect.

Search keywords: Zopiclone not working with Citalopram
Zopiclone is not shown to have interactions with anti-depressant drugs like Citalopram. It shouldn’t have an effect on the efficiency of the Citalopram you are taking.

Search keywords: Rhovane stop taking
Depending on your dose, you may need to slowly taper off of Rhovane (Imovane) (Zopiclone). If you are taking more than 7.5mg, you can reduce your dose by 7.5mg each week until it is altogether discontinued. Some people have trouble reducing their dose of Rhovane on their own; speak to your doctor if you have difficulties like this, as you may be addicted.

Search keywords: Can Olanzapine be taken with Eltroxin
There is no available record stating that Olanzapine cannot or should not be taken with Eltroxin. The two medications should be safe to take together.

Search keywords: Imovane withdrawal tinnitus
Imovane (Rhovane) (Zopiclone) is a medication that can be addictive, and some people experience withdrawal symptoms when they stop taking it. There is nothing credible on the internet that definitively states that a symptom of Imovane withdrawal is tinnitus, but there are some circumstantial allegations to that effect.

Search keywords: Eltroxin and anti-depressants
Eltroxin can interact with any medication that makes changes to the thyroid hormone and metabolism. To quote rxlist.com, “Concurrent use of tri/tetracyclic antidepressants and levothyroxine may increase the therapeutic and toxic effects of both drugs, possibly due to increased receptor sensitivity to catecholamines. Toxic effects may include increased risk of cardiac arrhythmias and CNS stimulation; onset of action of tricyclics may be accelerated. Administration of sertraline in patients stabilized on levothyroxine may result in increased levothyroxine requirements.” It is also stated on this site that Eltroxin can interact with SSRIs (Selective Seratonin Reuptake Inhibitors).

Search keywords: Amitriptyline and Imovane together safe?
According to my searches, there are no interactions between Imovane and Amitriptyline. The two medications should be safe to take together.

Search keywords: “Dexedrine doesn’t work”
See my above post, listed under “Dexedrine doesn’t work for me”.

Search keywords: Does Levothyroxine affect sense of smell
Levothyroxine does not appear to have an effect on a person’s sense of smell, but you could be experiencing a rare side effect that has not previously been recorded. Check with your doctor, especially if this is something you are concerned about.

Search keywords: Tinnitus Eltroxin symptoms
Tinnitus is not listed as a common side effect of Eltroxin, but as stated in an earlier blurb, this could be a rare side effect.

Search keywords: Can you take Melatonin with Risperidone
Kind of interestingly, Melatonin actually does have an interaction with Risperidone, but it’s a relatively positive one; Melatonin appears to reduce the severity of tardive dyskinesia when it is present as a side effect of antipsychotic therapy. You can absolutely take Melatonin with Risperidone, and it may actually help you if you’re suffering from tardive dyskinesia.

Search keywords: Symptoms of high dose of Eltroxin
Symptoms of taking a high dose, or overdose, of Eltroxin are varied and present mainly as symptoms of hyperthyroidism. These symptoms include fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating, headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia, tremors, muscle weakness, palpitations, tachycardia, arrhythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest, dyspnea, diarrhea, vomiting, abdominal cramps and elevations in liver function tests, hair loss, flushing, decreased bone mineral density, menstrual irregularities, impaired fertility, and seizures.

Search keywords: Interactions Melatonin Imovane
When using a similar medication – Ambien (Zolpidem), users reported a higher frequency of daytime sleepiness while also taking therapeutic doses of Melatonin. This could be the case with Imovane (Rhovane) (Zopiclone) as well, as the medications act in a similar fashion. You should be careful operating machinery or driving if you’re taking Melatonin, Imovane, or a combination of the two.

Search keywords: Eltroxin and Zoloft
There is a general warning about taking Eltroxin and antidepressants simultaneously that actually specifically mentions Zoloft (Sertraline): “Administration of sertraline in patients stabilized on levothyroxine may result in increased levothyroxine requirements.” -rxlist.com. If you’re taking Zoloft, you may need a higher dose of Eltroxin to obtain therapeutic benefits.

Search keywords: 300mg of Imovane
300mg of Imovane (Rhovane) (Zopiclone) is enough to induce an overdose in most people. If you have taken more than your prescribed amount of Imovane within a 24-hour period, it is recommended that you seek help on an emergency basis. Call your local health provider or visit an emergency room to make sure that you aren’t having a potentially fatal overdose. Symptoms of Imovane overdose include clumsiness, mental or mood changes, severe drowsiness, and unusual tiredness or weakness.

Search keywords: Eltroxin drink alcohol
See my above post entitled “Could you drink alcohol while taking Eltroxin“.

Search keywords: Eltroxin and vitamins
There is no specific evidence online that you will experience negative side effects while taking Eltroxin and various vitamins together, but you may want to check with your doctor about specific vitamins and their interactions with Eltroxin.

Search keywords: Tryptophan taken with Zopiclone
L-Tryptophan does not appear to have any interactions with Zopiclone, but you should check with your doctor before taking both of these medications together.

Search keywords: How to taper Levothyroxine
See my above post entitled “Taper off Levothyroxine“.

Search keywords: Can you take Omeprazole and Levothyroxine
There is nothing recorded on the internet that states that you shouldn’t take Omeprazole and Levothyroxine together; they should be safe.

Note: I am not a doctor, and the information I state on my blog is gathered from internet sources and physician’s handbooks. Therefore, it is important to speak to your doctor if you are unclear about something or if you have more questions that I am not qualified to answer.

Dexedrine?

I’ve been on Dexedrine (Dextroamphetamine) for about 5 doses now and things aren’t looking great. I’m not sure if I’m receiving any benefit from it, but I’m going to give it another two days and then call my psychiatrist. He instructed me to call him before I increase my dose, which will probably go up from 20mg to 30 or 40mg. On the plus side, I’m not experiencing any negative side effects such as increased anxiety, increased tics, nervousness, or worsened acne. The absence of any negative side effects does however suggest to me that there is room to go higher on the dose. As we’ve learned from other medications, I have a huge natural tolerance to most prescribed drugs and it often takes double the standard dose to affect me in any way.

In other news, my other medication plans are going well. I’ve had a bit of trouble sticking to the routine with the Clindoxyl (Clindamycin and Benzoyl Peroxide) cream every night and as a result my acne has flared up a little bit, but I think I can get it back under control if I go back to using it every night, as prescribed. I am starting to see a lessening in the overall effect of the Imovane (Rhovane) (Zopiclone) that I take (22.5mg nightly) and I’m thinking that by my next psychiatry appointment (February 17th) I may need to go back up to 4 pills or 30mg. The L-Tryptophan has helped a little bit – just enough that I’m going to keep taking it, but it’s not had any dramatic, life-changing effect on me. It’s harmless to take for extended periods of time though so I think I’ll stick with it.

I’m out of needles, which is both a cause for celebration and worry – I’m pleased because that means I’ve reached my hundred-shot mark; I’ve been on Hormone Replacement Therapy for 100 weeks! Yay! However I’m a bit worried because I don’t have the supplies to do my shot tonight. I’ll have to trek across the city tomorrow to buy more; maybe my mother will be compliant and take me in her vehicle.

That’s all for now; take care, everyone, it’s cold out! Well, at least it is here.