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FitTips for One and All - Vol. IX, No. 4

FitTips for One and All
Volume IX, Number 4
2011

Presented by Fitness for One and All
Director: Gary F. Zeolla

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Doctors have not been able to provide any help. Part of the problem is the medications they prescribe cause negative side effects that prevent me from taking them. The main side effect I get is that I am unable to sleep at night, but I have experienced other problems as well.

In addition, most every test the medical doctors run come back negative, so they basically say there is nothing they can do for me. For instance, one of my main problems is that I feel like I am allergic or sensitive to just about everything. But blood and skin scratch allergy tests have come back completely negative. It is at that point that the doctors throw up their hands and tell me to see a psychiatrist.

That always seemed to me like a cop-out, as I do not think my problems are just "all in my head." So I resisted for a while, but after a particular bad episode in August 2010, I started seeing a psychiatrist.

The psychiatrist has tried prescribing several different medications. Most again caused negative side effects or simply did not help at all. But I am taking two of them on an ongoing basis. In this article I will discuss in some detail the two medications I am taking and briefly mention some of the others I have tried, while over viewing what my experiences with the psychiatrists have been in general.

Note: All medication names are registered trademarks of the respective companies.

Klonopin
(Generic name: Clonazepam)

As mentioned above, Klonopin was one of the medications the neurologist had me taking back in the ‘90s. That again was for neurological tics. I was taking 0.5 mg at that time. But I began taking it again in August of 2010. That was after I had a severe allergic reaction that left me almost totally paralyzed.

I had my dad take me to the ER. I have had such episodes before, but this was the worst one I had in quite a while. I was fed up and was hoping that this time with the doctor seeing me in such a bad condition I would be admitted to the hospital and actually get some help. So there I was unable to move, being pushed around in a wheelchair by my dad. I figured the doctors would get the message that something was seriously wrong with me and try to do something about it.

But I waited around for several hours, which only caused my symptoms to get worse due to the smells in the hospital. I particularly had problems when they stuck me in the hallway on a stretcher, since all of the ER rooms were taken. I told them that the smells in the hallway were really causing me problems, but no one seemed to care.

After running some tests that came back negative, I was told there was "no medically necessary reason" to admit me! How bad did I have to get for there to be? All they could suggest was that I be admitted to the psych ward. But I was told that once I was admitted there, I would have to stay at least three days.

Given how much the smells in the hospital were bothering me, I knew that if it was as bad in the psych ward, I would stay paralyzed as long as I stayed in the hospital. So I decided not to go into the psych ward, but I agreed to see a psychiatrist on an out-patient basis.

Before I left, I was given a prescription for 0.5 mg of Klonopin. I'm not sure exactly what they thought the Klonopin would do. It has not in any way helped reduced my feeling of being allergic to everything, but they did say it might help with the stiffness that can result when I am exposed to allergens. And it does seem like it has done that. I have not had an episode of being completely paralyzed since I have been taking it.

But the most noticeable effect I have had from it initially was that it helped me sleep at night. That first night I took it I slept for about nine hours straight through, probably the first time in years that I had slept an entire night without being woken up by some problem in my body or some noise outside. I even slept through the two motorcycles that wake me up almost every morning. See Motorcycles, Barking Dogs, and Sleep Deprivation for details in that regard.

Unfortunately, that deep sleep only lasted that night. By the next night once again I was awoken by the motorcycles in the morning, but at least I slept well until that time. But after a few weeks, the Klonopin no longer seemed to help me sleep at night. So I asked my primary care physician (PCP) to increase the dosage to 1 mg, which he did. And that once again helped me sleep, at least until the motorcycles wake me up. But with the drug, I am now able to fall back asleep at least most of the time, something I never could do before,

When I finally saw the psychiatrist (which took several weeks), the Klonopin once again seemed not to be helping as much. I wasn't sleeping as much, and I was getting somewhat stiff from allergic exposures, but not completely paralyzed. She increased the dosage to 2 mg. I stayed at that level for the next several months. And that again helped with sleep and to keep me from getting stiff.

But then the psychiatrist I was seeing left. And that office wasn't getting a new psychiatrist in for the foreseeable future. And my PCP would not prescribe the Klonopin anymore. So I tried going off of it by gradually reducing it by breaking the pills in half. But 1 mg. did not help me sleep as well at night, and once again I was getting a little stiff from allergy exposures.

The office I was going to got an interim psychiatrist, so I went to see him. At my first appointment with him, I started getting stiff just from the smells in his office, and I remained so for the next 24 hours. So it really bothered me at his office. I had him increase the Klonopin back up to 2 mg, and that has helped me sleep a little better at night, and I haven't' gotten stiff since from allergy exposure.

Bottom line on the Klonopin, it does seem to keep me from getting stiff if I keep the dosage high enough, and it does help me sleep at night. But it also might be making my fatigue worse. At the very least, sleeping better at night has not made me feel better during the day like I had hoped.

I should also mention that the Klonopin has almost completely eliminated my sex drive. Given that I am single, and with my health problems, there is little chance of that ever changing, that is not a major concern for me. But I am sure it would greatly bother most people. I should also mention that the Klonopin seems to work best if taken on an empty stomach.

Risperidal
(Generic name: Risperidone)

When the initial psychiatrist increased the Klonopin to 2 mg, she also prescribed Risperidal, 1 mg daily. The Risperidal is best taken by letting the pill dissolve on the tongue. This drug also seems to make me drowsy, so I take it at night along with the Klonopin, and it is probably partially responsible for helping me to sleep better at night. It also helps control my mood.

Previously, when I would get an allergic reaction, especially to something that didn't make sense, I would get very emotional and upset. But the Risperidal helps prevent such emotional reactions. That is good. But the problem is it makes me feel somewhat "blah" all the time, meaning, I might not get as emotional in a negative way as much as I used to, but I don't as emotional in a positive way either. I just don't get excited about things as much as I used to. When I was still trying to train for powerlifting (more on that later), I found it hard to get "psyched up" for heavy lifting. Also, as with the Klonopin, it might be increasing my fatigue some, despite helping me to sleep at night.

The psychiatrist tried increasing the Risperidal to 2 mg at one point, but that left me feeling much too "hazy" in the mornings and did not provide any further benefit, so I went back to just 1 mg.

When the psychiatrist left and my PCP would not prescribe the Risperidal either, I tried stopping it, but once again, I started getting very emotional when I was in an allergic reaction, so I had the interim psychiatrist re-prescribe the Risperidal.

Various Sleep Medications

Before taking the above drugs, since I was rarely getting a good night's sleep, my PCP tried prescribing a couple of sleep medications. First he prescribed Rozerem (ramelteon). It worked great in helping me sleep through the night. This was in the winter, so I had no motorcycles waking me up. But the barking dogs that had been waking me up most nights didn't seem to bother me. But the effect only lasted for all of ten days, and then it stopped working. And not only did it stop working, but the Rozerem began to seem to keep me from being able to fall asleep, so I stopped taking it.

Then my PCP prescribed Ambien (zolpidem). It did help me sleep, but not very soundly. I was still awoken by the dogs and with it now being summer, the motorcycles. But I was sleeping better than I had been. But after a few weeks, the Ambien also gradually lost its effect and then stopped working altogether.

Later the psychiatrist prescribed Sonata (Zaleplon). The first night I took it, I slept too much, over ten hours, even sleeping through the motorcycles. But at that time I was taking the Klonopin and the Risperidal. So I think the three of them together was too much. As such, I figured it best to not take the Sonata every night.

I figured I'd only take it on the nights when I was having problems falling asleep. Or, since the literature said you only needed to be sure you had four hours of time to sleep, not eight like the other two medications, I'd take it when I got woken up by something like a motorcycle in the early part of the night. I figured that by only taking it occasionally, it wouldn't lose its effectiveness like the Rozerem and Ambien did. But that was not the case. Again, it worked great for these purposes for a few nights, but that was it. It stopped working altogether, and then like the Rozerem seemed to keep me from falling asleep. So I stopped using it.

So altogether, my experiences with sleep prescriptions has not been good. They might work for a short while, but that is it.

Other Psychiatric Medications

The psychiatrist I was initially seeing was convinced that my allergic feelings, stiffness, and other problems were all psychosomatic. So she tried one drug after another that she thought would help my symptoms. Specifically, she prescribed in order: Celexa (Citalopram Hydrobromide, 20 mg), Prozac (Fluoxetine HCL, 20 mg), Xanax (Alprazolam, 0.5 mg), Seroquel XR (Quetiapine, 150 mg), and finally Luvox (Fluvoxamine Maleate, 50 mg).

However, none of these drugs helped at all in controlling any of my symptoms, and they all caused me negative side effects. It's been months since I took any of them, so I cannot remember exactly what side effect which drug caused. But basically, either they would keep me from sleeping at night, or they would leave me feeling "hazy" or in a drug daze all day long.

Cymbalta
(Generic Name: Duloxetine)

Since I suffer from fibromyalgia, the intermit psychiatrist gave me some free samples of Cymbalta.(30 mg). However, the main benefit of Cymbalta is supposed to be relief from chronic pain, which most sufferers of fibromyalgia experience. But that is not my main problem with it. The fibromyalgia in my case mainly causes me to be very fatigued. Pain is only a minor and occasional problem. But what the Cymbalta did was to make my fatigue far worse.

But I should mention that it also was helping me to sleep more soundly at might. In fact the first night I took it I once again slept through the morning motorcycles for just the third time in the about six years they have been waking me up. But by the second night that did not happen. And each night it seemed to help less with sleep, and with it increasing my fatigue, I stopped taking it after 10 days.

Continuing Treatments

After all of the experimentation, I figured there was no use in seeing the psychiatrist anymore. I simply did not accept her diagnosis that my symptoms were all psychosomatic. I believe there is something truly, physically wrong with my body. It's just that the medical doctors have not been able to figure out what that is.

Since none of the drugs were helping at all, except for the Klonopin and Risperidal, she told me that I'd be able to get my PCP to prescribe those drugs. And given how much it bothered me allergy-wise in her office, my plans were to stop seeing the psychiatrist and just go to my PCP, whose office did not bother me as much. But when I went to my PCP, he said he would not prescribe psychiatric medications, that despite the fact that he had prescribed the Klonopin a year before.

What that meant was I had no choice but to go back to the psychiatrist if I wanted to continue with those drugs. But when I called to make an appointment, it was then that I found out she had quit and there was as of yet no replacement. That's when I tried stopping the Klonopin and Risperidal, but ran into the problems mentioned. But later they got the interim psychiatrist and I made my first appointment.

My Life Today
(August 2011)

My experiences with the various medications and with seeing a psychiatrist have only been slightly helpful. As mentioned the two drugs I am taking do help me sleep better at night, seem to prevent me from getting stiff, and help control negative emotional reactions to allergic exposures.

However, during the year now that I have been seeing a psychiatrist and taking these drugs, my health has worsened. My fatigue is now worse than ever. All of my other symptoms, especially my feeling of being allergic to everything, have also worsened. It is to the point where I can barely function at all.

Meanwhile, I had to give up on powerlifting altogether. A year ago, I was injured and not lifting heavy for that reason. But as the past year went on, the fatigue was making it harder and harder to make it through a workout, and, as mentioned, the Risperidal was making it hard to get psyched up for a heavy lift. And along the way, my strength seemed to be gradually lessening. Then around Memorial Day (2011), my strength really seemed to start to nose dive. Weights I used to use for warm-ups were now feeling so heavy I had to use them for my work sets. Meanwhile, my injuries simply have not healed fully.

As a result, just recently, I gave up on lifting weights altogether. I just couldn't do it anymore. So now instead, I am just going for short, slow walks. That's a far cry from the intensity I used to work out at. But it is the best I can manage.

And finally, before anyone recommends I try alternative treatments, I've already gone that route. I detail my experiences in that regard on the Web site (see Dealing with Health Difficulties). But basically, I got a little help but then got much worse. That is why I turned to medical doctors and medications. But that has proven just about as useless as well.

All material in this newsletter is copyrighted © 2011 by Gary F. Zeolla or as indicated otherwise.

8/24/11