View Full Version : Flattened my circadian rhythm... time to talk to my psychiatrist


bluefoxicy
03-16-17, 01:31 PM
The side-effects have toned down. Mild fatigue, mild manic-depression, more susceptibility to anxiety, heart rate elevation (by 13 points over baseline). Strattera at 80mg had me at 109bpm for a few days if I moved at all--I had to sit still for half an hour to get down to 102, and then by an hour I was down in the 90s if I stayed calm and relaxed.

Looks like serotonin syndrome, and feels like when I took too much SAM-e (don't do that). Mild serotonin syndrome. It probably isn't serotonin syndrome, but I bet it's too much serotonin. I've been like this for over a month; in my case, I can't tell if I'm fine or I'm just resilient enough to not crack under that kind of insanity.

On the plus side, I've found I can suddenly sleep without Suvorexant! That was a no-go before, to the extreme--Suvorexant was the only thing that would actually make me sleep. Last time I tried to stop taking it, I went 4 days with 1-2 hours of sleep per day, then took one of my remaining stock, slept fine, and called in a refill; before that, I had days when I slept 1 hour on the maximum dose of Eszopiclone. I also no longer need ~20mg of Melatonin, so yay.

Check out what happened when I got into the 60mg dose of Strattera. (http://i.imgur.com/cNSTprb.png) You can see my circadian rhythm flattening out, reflected by my heart rate. For reference:

https://image.slidesharecdn.com/areyoumanagingthesignificanthazardoffatiguecausedb yshiftwork-140915224219-phpapp02/95/are-you-managing-the-significant-hazard-of-fatigue-caused-by-shiftwork-7-638.jpg

Alertness. Body temperature also follows this pattern. Heart rate seems to, as well.

Methinks I should back down from the full 80mg dose.

sarahsweets
03-16-17, 03:44 PM
Those readings you linked to: how can I see the part about circadium rhythm? I dont think I am understanding them the way I should. I also didnt know circadium rhythm was something you could measure like that.

bluefoxicy
03-17-17, 10:00 AM
Those readings you linked to: how can I see the part about circadium rhythm? I dont think I am understanding them the way I should. I also didnt know circadium rhythm was something you could measure like that.

Proxy measurement. Circadian rhythm isn't a thing you can measure; your body changes during the day, and a lot of things are impacted. This includes body temperature (https://www.sciencedaily.com/releases/2010/10/101014144314.htm), alertness, and blood pressure and heart rate (http://hyper.ahajournals.org/content/18/2/199).

the 24-hour rhythm of heart rate may reflect an endogenous circadian rhythm, amplified by the effect of sleep

So what's going on is this:

The typical blood pressure and heart rate patterns were bimodal with a morning acrophase (around 10:00 AM), a small afternoon nadir (around 3:00 PM), an evening acrophase (around 8:00 PM), and a profound nocturnal nadir (around 3:00 AM).

There's a small low point in the afternoon in heart rate and blood pressure. You can see that on my early graphs.

I don't have any such low point anymore. The variation is essentially wake-sleep, instead of curvalinear. The two-peak, three-trough topology is replaced by a nearly-square topology.

I might respond a touch strongly to Strattera. They started me on 25mg; the first pill kicked in in under an hour, and I had zero affect for 3 days. I was completely zombified, like a huge dose of methylphenidate. This stuff has some serious kick to it.