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.

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.

Medication Profile: Effexor (Venlafaxine)

Brand name(s): Effexor, Efexor, Alventa, Argofan, Trevilor

Generic name(s): Venlafaxine

Street name(s), if any: None known

Available form(s): Capsule, tablet

Available dose(s): Regular Release: 25mg, 37.5mg, 50mg, 75mg, 100mg.
Extended Release (XR): 37.5mg, 75mg, 150mg.

North American availability: Available in Canada and the US.

Class(es): SNRI (Serotonin-Norepinephrine Reuptake Inhibitor)

Method(s) of action: Venlafaxine blocks reuptake sites in the brain, thus leaving more Serotonin and Norepinephrine available, which is thought to increase mood and alleviate the symptoms of depression and certain anxiety disorders/conditions.

Most commonly prescribed for: Depression, anxiety.

Also prescribed for: Diabetic neuropathy, migraine prophylaxis, obsessive-compulsive disorder, cataplexy, orthostatic intolerance.

Possible side effect(s): headache, nausea, insomnia, sexual dysfunction, dry mouth, dizziness, sweating, decreased appetite, abnormal ejaculation, hypertension, vivid/abnormal dreams, akathisia (agitation), decreased libido, increased yawning, apathy, constipation, ongoing IBS (Irritable Bowel Syndrome), fatigue, vertigo, orthostatic hypotension, impulsive actions, “brain zaps” (electric shock-like sensations), increased anxiety at onset of treatment, memory loss, Restless Legs Syndrome, cardiac arrhythmia, increased serum cholesterol, gas or stomach pain, abnormal vision, nervousness, agitation or increased anxiety, panic attacks, depressed feelings, suicidal thoughts, confusion, neuroleptic malignant syndrome, tremor, dizziness, allergic skin reactions, external bleeding, serious bone marrow damage, hepatitis, pancreatitis, seizure, tardive dyskinesia, difficulty swallowing, psychosis, hair loss, hostility, activation of mania/hypomania, weight gain, weight loss, homicidal thoughts, aggression, depersonalization, visual hallucinations, swollen and/or bleeding gums, frequent urination.

Possibility of tolerance: Low

Addictive potential: Low

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

Withdrawal symptoms: headache, nausea, dizziness, insomnia, nervousness, “brain zaps”.

Potential for abuse/misuse: Low

Drug interaction(s): cimetidine, haloperidol, ketoconazole, risperidone, indinavir.

Contraindication(s): hypersensitivity to venlafaxine or any other ingredients, people who have taken MAOIs in the past 14 days.

Overdose threshold: 900+ mg.

Symptoms of overdose: Tachycardia, coma, mydriasis, seizures, vomiting, ventricular tachycardia, bradycardia, hypotension, rhabdomyolysis, vertigo, liver necrosis, serotonin syndrome, death.

[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

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.

New Meds + Current Medication List

I saw my psychiatrist on Monday and we discussed the fact that Ritalin (Methylphenidate) didn’t seem to be doing anything for me. We went over our options and settled on Dexedrine (Dextroamphetamine) as our next choice in terms of stimulant medications. Hopefully this one will provide me with relief from my depression symptoms, but I’m not holding my breath. We also increased my dose of Effexor for longer-term depression treatment. Here’s an updated medication list:

Effexor (Venlafaxine): 187.5mg 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: 20mg in the morning – for Depression-related symptoms

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 (Updated)

Changes, shortages, small animals… I’ve got it all!

Effexor (Venlafaxine): 150mg nightly – for Depression
Imovane/Immovane (Rhovane) (Zopiclone): 22.5mg nightly – for Insomnia
Risperidal (Risperidone): 2.5mg nightly – for Tourrette Syndrome
Ritalin (Methylphenidate): 40mg in the morning – for Depression
L-Tryptophan: 1000mg nightly – for Insomnia (Note: When I got discharged from the hospital, they didn’t give me a prescription for this, so I’m not currently taking it.)

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: 2mg 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

That comes out to 8 pills every morning, 2 pills in the evening, and 13 before bed – 23 pills every day, or 161 every week, plus a shot once weekly and cream application every night. I’m a pharmacist’s best friend – or maybe their worst nightmare.

Current Medication List (Updated)

A few changes in the past week or two…

Immovane (Rhovane) (Zopiclone): 22.5mg nightly – for Insomnia
Risperidal (Risperidone): 2.5mg nightly – for Tourrette Syndrome
Ritalin (Methylphenidate): 40mg in the morning – for Depression
Effexor (Venlafaxine): 75mg nightly – for Depression

Erythromycin: 333mg morning and evening – for acne
Losec (Omeprazole): 20mg in the morning – for acid reflux
Delatestryl (Testosterone Enanthate): 60mg once weekly intramuscularly – for low Testosterone
Clindoxyl (Clindamycin and Benzoyl Peroxide): topically at night – for acne

Salmon Oil: 1000 mg in the morning, evening and nightly – for high cholesterol
Vitamin C: 500mg in the morning – for overall health
Multivitamin: 1 in the morning – for overall health
Melatonin: 2mg nightly – for Insomnia
L-Tryptophan: 1000mg nightly – for Insomnia

Most Common Search Responses

I’ve compiled responses to some of the most common searches that lead people to my blog. Here they are, by topic:

Search terms: Rhovane Withdrawal
Rhovane, which I refer to as Imovane (Rhovane) (Zopiclone),  can produce withdrawal symptoms. They include abdominal pains, aching, agoraphobia, anxiety, blurred vision, body vibrations, changes in perception, diarrhea, distended abdomen, feeling of unreality, flu-like symptoms, flatulence, food cravings, hair loss, heart palpitations, heavy limbs, increased allergies, increased sense of smell, insomnia, lethargy, loss of balance, metallic taste, muscle spasms, nightmares, panic attacks, paranoia, persistent & unpleasant memories, severe headaches, shaking, short term memory loss, sore mouth and tongue, sound & light sensitivity, speech difficulties, sweating, suicidal thoughts, tinnitus, unusually sensitive and fear. Whether you will experience withdrawal from Rhovane (and how strongly you will experience it) depends on how long you have been taking it for and  how much you have been taking. People on high doses of the medication or people who have been taking Zopiclone every night for over four weeks are at a higher risk for withdrawal system once they stop taking it. You should not abruptly stop taking Imovane (Rhovane) (Zopiclone) unless your doctor tells you to do so. You should also not start taking higher doses of it without your doctor’s permission.

Search term: Immovane
Imovane, which is a brand name, is also know by its other brand name, Rhovane, or by its generic name, Zopiclone. The Z-drugs, which Zopiclone is a part of, act on the same receptors as benzodiazepines, but they differ in molecular structure and actually classify as Cyclopyrrolones. Imovane is a hypnotic medication that is generally used for people who have Insomnia. Imovane is not generally indicated for use every day for more than four weeks, as tolerance, dependence, and/or addiction may occur. Imovane is not commercially available in the United States, but its stereoisomer, Eszopiclone, is. When first starting Imovane, some people experience a metallic taste that can last a few minutes to several hours. This tends to improve the longer you take the medication. Other common side effects include disruption of REM sleep, double vision, drowsiness, memory impairments, visuospatial impairments, dizziness, headaches, and fatigue. People with a history of drug addiction or drug abuse should not take Imovane because it has a potential for misuse. Certain drugs interact with Imovane; always check with your doctor that none of your current medications will interact dangerously with it. You should not drink alcohol when taking Imovane.

Search keywords: Can Losec cause low testosterone
From the research I have done, there are no reported cases of Losec causing low testosterone and it is not a listed side effect.

Search keywords: Eltroxin and Losec
Losec does not interact with Eltroxin – the two are safe to take together.

Search keywords: Omeprazole and Minocycline
Omeprazole (Losec) and Minocycline (Minocin) do not interact with each other and are safe to take together.

Search keywords: Zopiclone Anorexia Nervosa
Zopiclone (Imovane) (Rhovane) is not indicated in use for the treatment of Anorexia Nervosa, but some people with Anorexia Nervosa may be prescribed Zopiclone because they also suffer from Insomnia.

Search keywords: Atomoxetine vs. Zoloft
Atomoxetine, also known as Strattera, is a medication indicated for use in the treatment of people with ADHD. It helps them to focus, concentrate, and calm down. It has also been used in people with treatment-resistant Depression to boost their mood, increase energy and focus, and increase alertness. Zoloft, or Sertraline, is a an SSRI antidepressant that works on the serotonin in your brain. SSRIs like Sertraline are generally tried first before moving on to a medication like Atomoxetine.

Search keywords: Levothyroxine causing low testosterone
Low testosterone is not a listed side effect of Levothyroxine.

Search keywords: Sertraline for acid reflux
I have never heard of Sertraline being used in people with acid reflux. This doesn’t mean it can’t happen but my research doesn’t reveal any cases in which people took Sertraline for acid reflux.

Search keywords: Melatonin and Imovane
I personally use Melatonin and Imovane together with mixed success. It is not dangerous to take Melatonin and Imovane at the same time.

Search keywords: Eltroxin Depression
Eltroxin was one of the “energy-boosting” medications that my psychiatrist tried me on before I switched to another anti-depressant. It can be used to treat certain symptoms of depression such as low energy and low mood. Eltroxin is usually used in combination with an anti-depressant when used for that reason.

Search keywords: How to taper Zoloft
Tapering Zoloft depends on what dose you are on. If you are on more than 100mg per day, you should decrease by 50 mg each week until you have reached the new desired dose or you have discontinued the medication. If you are on 50mg per day, you can generally just discontinue the medication, but don’t do so without a doctor’s permission.

Search keywords: Mood drop Sertraline
There are several reasons why someone’s mood could drop while taking Sertraline. If they were previously on a different anti-depressant and switched to Sertraline, it could be that the other medication was more effective, or that the medication hasn’t started working yet. If you’ve been on Sertraline for a while and experience a drop in mood, you may require a higher dose of the medication.

Search keywords: Rhovane morning
It is not generally recommended to take Rhovane (Imovane) (Zopiclone) in the morning because it is a medication that is designed to make you sleep. Therefore, taking it in the morning could cause you to feel drowsy and might affect your ability to operate a vehicle or machinery.

Search keywords: Switching from Sertraline to Effexor
I  recently switched from Sertraline to Effexor and am waiting to see if Effexor has any effect on me. The process of switching from Sertraline to Effexor involves tapering off of your dose of the first medication and slowly increasing your dose of the other. You can start your first dose of Effexor while there are still small traces of Sertraline in your system. Your doctor will usually start you at a low dose of Effexor and work their way up until your dose is in the therapeutic range.

Search keywords: Strattera or Atomoxetine
Strattera and Atomoxetine are actually the same medications – Strattera is a brand name under Eli Lilly, and Atomoxetine is its generic name.

Search keywords: Taking Vitamin C with Eltroxin
There do not appear to be any interactions between Vitamin C and Eltroxin.

Search keywords: Imovane Melatonin
Please see “Melatonin and Imovane” above.

Search keywords: Do you need to taper Levothyroxine
It depends what dose you’re at. When i was taking 0.05mg of Levothyroxine, my doctor had me reduce my dose by half for a month before discontinuing the medication. Depending on your dose, you may or may not need to taper off of it. Check with your doctor.

Search keywords: Why isn’t Rhovane helping me sleep
Rhovane (Imovane) (Zopiclone) may not be helping you sleep because your dose might not be high enough. If you are already on the maximum dose, you might want to consider trying a different medication.

Search keywords: Anxiety Rhovane
Rhovane lists anxiety as a potential (but uncommon) side effect. Some people, on the other hand, find that it helps calm them before they fall asleep.

Search keywords: Zopiclone and Zoloft
Zopiclone and Zoloft do not interact with other – they are safe to use together. These two medications may be used by a person who has both Insomnia and Depression, Obsessive-Compulsive Disorder, or some form of Anxiety Disorder.

Search keywords: Zopiclone and Advil
Zopiclone (Rhovane) (Imovane) and Advil (Ibuprofen) are safe to use together. There is no drug interaction between the two.

Search keywords: Zopiclone Omeprazole
According to my research, Zopiclone and Omeprazole do not interact with each and are safe to take at the same time. It may be of note that most people take Zopiclone at bedtime, while Omeprazole is generally taken in the morning on an empty stomach.

Search keywords: Rhovane vs. Immovane
Rhovane and Immovane or Imovane are the same medication; Rhovane and Imovane are brand names for the medication Zopiclone, which is a sleeping medication.

Search keywords: Losec morning or evening
Losec (Omeprazole) is generally recommended to be taken in the morning on an empty stomach. This is in part to reduce the possibility of having acid reflux symptoms, which the drug is designed to treat.

Search keywords: Dexedrine and Advil
Dexedrine (Dextroamphetamine) and Advil (Ibuprofen) do not have any significant drug interactions and are safe to take together.

Search keywords: Rhovane and Risperidal
Some people may take Rhovane (Imovane/Immovane) (Zopiclone) and Risperidal (Risperidone) together because they suffer from Insomnia and Schizophrenia, Bipolar Disorder, Autism, or a Tic Disorder. There are no significant drug interactions between the two and they’re safe to take in unison.

Search keywords: Omeprazole and Eltroxin
There are no significant drug interactions between Omeprazole and Eltroxin. Someone may be taking these two medications because they have both acid reflux and a thyroid condition.