[Clemintine]

So, Recently I decided to go to the doctor for help with anxiety/sleep troubles...
Don't know how much history to give but I've had trouble with sleep all my life. I've taken herbal supplements, exercised and eaten like a normal person should... Nothing really helps. Even as a child I had a hard time with it, (dating back to when I was attending 1st grade) some with going to bed but more with getting out of bed and waking up in general. My friends would laugh about it at sleepovers, describing me as nothing but a shell of a human whose only purpose in life is to get back to sleep, screw however I managed to I just had to. As a teen it was bad on both accounts, getting TO sleep and getting out of it. My mom was I'm sure scarred by me in the morning (mentally!), she had to wrestle me from bed every morning with threats of putting me in the car in my pyjamas if I did not get up. Pretty sure I told her to go eat a cock one morning =/ I'm not that kind of kid I never spoke at her like that in my waking hours!
Now that I'm older (22) I've noticed it's changed. I have a hard time falling asleep... my mind is ravaged by horrible thoughts (or just plain annoying ones), sometimes about worries or daily life and dread for the day to come. Sometimes about nothing of importance but I would still be upset about it. I would imagine my family or loved ones dying, it could feel so real that I would cry myself to sleep. Sometimes I am incredibly tired, and I go to bed at a reasonable hour but still lie awake for a few hours before sleep hits me... listening to my brain prattle on and on. Sometimes I focus on myself to fall into a lucid dream, and follow my thoughts along until I notice them becoming more and more random.. sometimes it's enough to send me into sleep without trouble or I go lucid dreaming which is also fun. It's like a sort of meditation for me, but lately it hasn't worked. Thoughts fly in out of nowhere and knock me off my effort to sleep. Sometimes I try not to care if I fall asleep or not, saying I will get up if I don't. Or I imagine walking to work tomorrow in the rain and how much that sucks, usually those used to send me to sleep to escape the feelings of those thoughts. Nothing I taught myself to use for sleeping has seemed to work since this summer, not even telling my brain "okay it's sleep time now" doesn't work hah!
So I spent a month building my courage to go to the doc, I had a day where I started to think suicidal thoughts again. I have tried to commit before and I don't want to fall into that hell of self hate again, the next day I sprang to the doctor with a bird beating around inside my chest. Every noise scared the living daylights out of me but I walked steady to the office sat down and waited.
I told him a bit of my history, but froze up short about my depression and suicide. I hate telling someone in person that "I haaaate myselff and i wanna diieee" I sound like a whiney emo girl... I can't stand it, and I can't bring myself to say it in the way I need too.
He prescribed me Seroquel 25mg which put me to sleep nicely enough, but I would still wake up during the night, toss and turn and fall asleep again. During the day it felt foggy and dizzy, I felt less organized with my thoughts and sometimes more edgy and agitated throughout the day. This pill did not help with much but getting to sleep. Getting put to sleep rather it was a cloud of drowsyness taking over me.
I went back.. explained to him how it had made me throw up the last time I took it, he said that's no good... how about we try an anti-depressant?
He asked what medication my mum takes, Risperidone clonazepam and trozodone... all of which he said never mind I won't prescribe you any of those! So he stuck with Desvenlaflaxine... Pristiq 50mg, I tried again to explain that I had felt depressed before. I didn't get my point across again, I couldn't bring myself to say it to him rightly, I'm pretty soft spoken in person, so he assumed I meant some normal depression as reaction to some sad life event.. he said that's normal. I nodded and didn't really elaborate, thinking well this anti-depressant should help me either way. He said I can start right away with this pill.
So I go home, whip out the side effects and pill interactions and read through them carefully as I do.
Now sorry about my long rambling.. this is where my question happens haha... I have been taking a diet pill called Fruta Planta, Some crappy but supposed to work imported from China. Yes I know the horror stories... they have hay and fibreglass shards in those pills, they cause cancer, oh all these horrible things... but they worked, so I kept taking them. I don't need to take these, I'm actually underweight when I started taking them, but that's another problem. Either way in my FP research I found that it might contain Sibutramine which is one of the specifically listed medications that you should not take with pristiq
... I felt silly I hadn't mentioned this to the doc, but as I said earlier it would have sparked more questioning from him about why I would take a pill to lose weight I didn't need to lose. I read over the adverse effects but I guess I did that thing where you read something but didn't actually absorb it, I didn't notice and I ended up starting pristiq anyway, thinking if I didn't take FP the following days it would be fine. I have not taken FP since starting pristiq.
After a horrible sleep with waking up every hour after only a solid 3 hour rest I looked over the side effects again. These two meds when combined can cause serotonin syndrome! If I had taken any med before pristiq that might react badly to it I should wait 14 days before starting pristiq.. which I hadn't! I looked over the side effects of serotonin poisoning... I had to have had three of the combined symptoms, so far I had only one: Restlessness.
So.. I informed my boyfriend if he sees any more of these symptoms and I'm not noticing to keep his eye out and let me know or drag me to a hospital or whatever.
Now I feel silly, but Fruta Planta may or may not have even have sibutramine in it (I've been taking it for 3 months). I could be over reacting... I've only taken this Pristiq pill 4 or 5 days and every night has bee utter hell sleep wise. I get about 3 hours.. then bam, horribly restless. I honestly cannot keep still, I try to hold my body still but my foot moves.. then my leg, hips, butt and I'm flipping and twirling and moving around stretching my legs out to get a stretch out that doesn't go away. I'm used to getting very little sleep but not as disturbed sleep as this, I have never flailed more in my life.
I forget if restlessness is a side effect to pristiq... But if it was, could it get this bad? Or do I have even a small case of this poisining? Or am I overreacting? =/ It's said to crop up this fast, within the first few doses of the interacting meds... arg.
Any advice would help me out, weather to quiet my mind on over thinking about it, or to get me into action to do something about it without seeming too hyper about it...
Also I know I could have avoided this by telling the doc... but all I really wanted was a way to fall asleep, a way to quiet my head so I could get to bed without running thoughts. I sort of regret it now, but I don't want to have the rest of my brain pried into, my losing weight and depression, I can deal with on my own so far... I don't want any of that attention. I think my sleep is a big part of it, and if I can just get some I could get through the rest fine.
Thanks everyone, really appreciate your help as always, and sorry about my book length rambles!

[DrBill100]

Without knowing the ingredients of Fruta Planta it isn't possible to determine clearance or any possible cross-reaction. However, the primary indicator would seem to be the time interval. Serotonin toxicity is a rapid onset reaction to a mixture of medications.

Additionally, sleep disturbance is a side effect common to Pristiq and to most antidepressants and you have a history of sleep disturbance. Hopefully these factors weigh against a serious serotonin reaction. Nonetheless, the sleep disturbance and associated concerns should be reported to the doctor.

When you get over your inclination to play hide and seek with the doctor you'll obviously have a better chance of obtaining either a proper combination of medications or other adjunctive therapy to address the totality of your symptoms.

Personal disclosure is always difficult but essential to any therapeutic relationship.

[J_9]

I have to completely agree with Dr. Bill. Pristique should not be taken to help sleep, but rather to help with lethargy.

Unfortunately you did not disclose your complete history to your doctor, and as such, he was not able to prescribe the proper medication for your specific needs.

I am also concerned about the medication your mother is on. Is there any chance that her disorder has been passed down to you?

Clonzopam (Klonopin) is a good medication to induce sleep.

What concerns me as well is that you are only giving the medications a few days before giving up. Medications in this class can take as long as 4 weeks, sometimes more, before the full and complete effects are felt.

If you are thin/underweight, and are taking this diet supplement, you may also have an eating disorder that should be addressed.

Please make an appointment with your doctor for full disclosure of your past as well as your current symptoms.

[Clemintine]

Thank you DrBill & J9! Your replies are appreciated! I think I'm in the clear for serotonin poisoning... no other side effects manifested other then that bad sleeping, which probably is just the Pristiq.
It's hard for full disclosure, I've tried before and it's just tough for me. I write out a list of everything in bullet points, as I feel that's the best way I can without bawling and looking foolish. I tell the doc I have a list and he says go ahead, I begin to read and after the first thing I say he cuts me off. Not in a harsh way but enough to break me out of the little courage I summoned to say what I had to, and only to ask a question or something. I can't help but back off from finishing what I wrote after that.
This new doctor I'm going to now is much much better than any others I've seen, so I have hopes I might be able to open up more to him, though I'm not a patient of his I just keep going to the same walk in clinic to catch him.
When I started seroquel that's what I thought, that it would take a full month to see if it helped... but I only go back when the doc says to and not any sooner. He informed me to return in 14 days after starting seroquel, so I did and explained my symptoms and he switched me to Pristiq. Now on this new med he told me to return in a week and a half (I only have a 2 week sample of it) and so I will and tell him the trouble sleeping I've been having and see what he says.
As to my mums disorder she has Psychotic depression, pretty badly. I've told the doctor of my mum and my brothers (my oldest brother only last year was diagnosed with Unipolar mania) conditions so he knew my family history. Her therapist has warned her and my father to keep their eyes on the kids for any inkling as to us getting it too... I grew up in a pretty weird household, my dad has has admitted to seeing some of the signs in me before, though I think he might have just been overthinking it? Maybe I hope hah...
As to me having an ED I'm sure I do, but at worst EDNOS, I don't really fit into any other category. It really fluctuates with my state of mind, how depressed/happy/sleepless/self-confident I am and all that...
I do have a fast paced mind, if something hasn't worked in 4 days I get irritable it hasn't. I remind myself, and my boyfriend does, that it can take a month for it to really work... But I can't handle a month of sleeping like that, or not sleeping rather. It's hell.
In my head it feels like it's been a month already but in reality it's been almost 2 and a half weeks really =/ things just get processed quickly all up in my cranium!
The doc did say (not sure if I mentioned this yet) if I get any bad side effects, just stop taking the meds. Yesterday I skipped taking Pristiq (I actually forgot) but then I decided well I might as well see how my sleep is tonight without having it. I slept soooo good. I had barely any falling asleep trouble, I woke up once all night and fell right back asleep after, it was so nice. I'm trying again tonight without having had Pristiq for two days now and seeing just how my sleep is again... I'm not sure if I'm messing this up royally, but he did say if it bothers me to just stop. My boyfriend and I live together so I have someone watching me in case I feel worse all of a sudden or react bad and such. I haven't felt any different so far, just pretty much level and normal (Well normal for me).
If this night goes well for sleep, should I just not take Pristiq again? Or should I try one more night on it and see for sure if that's what affects my sleep? D:
Thank you again guys haha...

[J_9]

If you take it at night, why not try taking it in the morning as soon as you wake?

[Clemintine]

I have, I took it three times at 5pm, then switched it to 10 am for when I woke up for three days.. same results!

[Clemintine]

Not.. 3 times in one night.. but 3 days I tried taking it at 5pm.

[J_9]

Next time you go to the doctor you should explain that you are very nervous talking about your problems and you feel more comfortable if you just give the doc the list. Let the doc read the list, then let the conversation carry itself from there.