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Horrible flare up by taking hydroxyzine


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(Again, sorry for my english)

And that's it guys. I got HPPD 7 years ago and it was a real torture at the beginning. I remember how bad I was freaking out the first years (panic atacks the whole day and paranoid as hell). I believe it got better after some years, or I don't know if I got used to it but the fact is that I didn't mind a shit about the visuals. It took about 4 years for that.. I can not say that I was recovered because I've never been able to carry a normal life due to the DP/DR, brain fog and anxiety.

Some days ago I took Hydroxyzine for two days, which caused me a flare up and I'm in hell again tripping as if I had just done acid. Now I feel the visuals (specially the trails) DP/DR and brain fog even stronger that when I first got HPPD.

During the last years the visuals were not bothering me any more although the DP/DR and brain fog never went away and it was always bad. I've been struggling with DP/DR and brain fog during all this years but now it also got worse.

I'm really pissed off. Now i'm 29 years old and worse than ever! Now it's not so much about panic like it used to be when I first got this, it is about that the visuals are really, really bothering me and making me extremely depressed because I can't percieve the world normally and this is somehow scary. I don't even want to move my hands and I avoid looking at them because I see some insane trails. The trails are driving me crazy!!, they are VERY strong. I don't know if I got permanently worse, I'm scared... I feel my brain so fucked up, so confused. I feel lost (the brain fog is so intense) How the hell can I get back to reaity?? My mind is in another world, just like when you trip. This is disgusting..... I'm considering trying Keppra, but I don't know.

What would you recomend guys?

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Hydrozyzine is an antihistamine with a sedative effect and I was using it to help sleep. The trails are freeking me out! are so annoying. I can't believe I have such a nasty trails without taking acid, it's really insane.

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Have you ever tried any medications for your symptoms? (anxiety, visuals, etc.) And if so, how did they affect you?

Yes, I've tried several medications and most of them make this worse but only for one or two days in my case (Just like the day after drinking alcohol). The only thing that really helps for anxiery, and somehow DP/DR is Klonopin but I got addicted to it (I used it even before HPPD). I've been on and off klonopin during many years. The problem is that I hit tolerance really fast and I need some super doses, so I keep moving the dose.

I would say that after some years the visuals got better without any medication until now that I've experienced a hell of a flare up with Hydroxyzine.

Something that I've never been able to overcome is DP/DR and brain fog. (Only gets better with benzos or alcohol)

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Hydroxyzine seems to have several effects, not just antihistamine ... so it is difficult to comment on your reaction. Wiki isn't the best place for information but it is a good start (you can always dig further to verify accuracy) http://en.wikipedia....iki/Hydroxyzine

However, the text states "antipsychotic properties". Since "long-term prescription of hydroxyzine can lead to tardive dyskinesia" ... this further confirms significnt antipsychotic pharmacology. Antipsychotics reduce dopamine and are likely to cause the problems you mention.

While "it has negligible affinity for the mACh [acetylcholine] receptors", this affect is not negligible since "dryness of the mouth and constipation caused by antimuscarinic properties of hydroxyzine"

To summarize: Both dopamine [largely] and acetycholine[slightly] are known to affect HPPD. IMO you would be a good candidate to try dopamine increasing meds such as Sinemet. Keppra might be something to try if you can't get Sinemet (though its track records is less).

As a side statement (little to do with this topic) it states "Hydroxyzine's antiserotonergic effects likely underlie its usefulness as an anxiolytic". This is curious since doctors widely prescribe the opposite (SSRIs - serotonin increasing meds) to treat anxiety. So this flies in the face of common thought and practice.

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Thanks for the info.

I've had bad reactions several times with differents medications but only temporary. This time has been like taking acid again and it looks like my HPPD is long term affected now by hydroxyzine.

I never heard about Sinemet before, but I was looking for it now and it's available in my country (I'm from Chile). I thought that Keppra was the number 1 promising medication for HPPD by this moment. How would it be a Sinemet dose for HPPD? My DP/DR and brain fog is pretty bad now, do you think that Sinemet can help with this?

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I never heard about Sinemet before, but I was looking for it now and it's available in my country (I'm from Chile). I thought that Keppra was the number 1 promising medication for HPPD by this moment

The #1 med is Klonopin

IMO, #2 is Sinemet ... but the community has to confirm that over the next few years. And Dr A's drug trial was much stronger than Sinemet alone.

Keppra has a few excellent reports. So do opiods (perhaps more). Then various blood-pressure meds and other anti-anxiety stuff.

Usually antipsychotics give negative results. SSRIs tend to negative. However, there are members who feel they have benefited. So, in the end you have to just try stuff.

You mention "I've had bad reactions several times with differents medications but only temporary" - it would be helpful if you would list the meds and what the temp bad reactions for each were.

Anxiety is extremely common with HPPD ... comorbid or part of it. Some members have visual symptoms flare up with increased anxiety (though I am not one). So this is a logic place to start, and you already are familiar with Klonopin.

Sinemet is a dopamine increasing med. There are several. It is used primarily for people with Parkinson's disease. It is two meds: carbidopa and levodopa, and sold in different ratios. Levodopa is the 'active' part. Another name for levodopa is L-dopa. Dopamine is made from levodopa.


How would it be a Sinemet dose for HPPD?

IMO, Sinemet is a relatively mild med ... as far as meds go. But with all meds, always start with small doses and work up. Since you report you are sensitive, all the more reason. There is no need to shock/surprise the body ... and some with HPPD are very sensitive. The formulation of Sinemet to work with is Sinemet 25/100. The maximum dose of this formula is 4 pills a day - 400 mg levodopa (other formulas go up to 10 per day - 1000 mg levodopa).

I've always worked with 1/2 pill at a time. My maintenance dose is 1/2 pill 3 times per day. Another member here uses 1/2 pill 4 times per day. Most people so far do not report bad reactions from this med ... either it helps a little, a lot, or not at all (like water). One member reported feeling faint and heart racing - this is actually a predictable response but unusual at such a low dose. Long term use of this med needs to be watched by doctors particularly if dose is above 3 pills a day for years.

So, if your doctor gives it for you to try: Get Sinemet 25/100 (generic is carbidopa/levodopa 25/100). Try 1/2 pill in morning only for a few days. If you don't notice anything, take 1/2 pill 2 times a day. Then 1/2 pill 3 times a day ... and so on. If 3 whole pills a day does nothing, then there is little reason to continue. Either you don't need the med or you need lots - which should be more closely monitored.

As for members reactions. The ones that it worked for they knew quickly. One member said that within a hour of first dose he could 'feel' (fixed DP/DR) for the first time in 5 years.

About the subject of dopamine and HPPD, please read these links:




Note - this is not an endorsement to try tolcapone. No one should try tolcapone without close (weakly) monitering by a doctor. Tolcapone is not Sinemet ... it is a strong booster for dopamine. Tolcapone can destroy your liver.

If you print the article Dr Abraham wrote and present it to your doctor, it may help. Note: There is NO treatment standard for HPPD. And this article talks about Tolcapone. Tolcapone must be taken with Sinemet - so just target the later with your doc. Does you doctor(s) recognize you have HPPD?

Be sure to do a forum Search: Sinemet and read what member say.

My DP/DR and brain fog is pretty bad now, do you think that Sinemet can help with this?

IMO, Sinemet only will help certain symptoms. OEVs, CEVs, snow don't seem to be affected. But DP/DR, visual contrast (night vision), visual acuity (sharpness), trails/tracers, brain fog (some help), anxiety (some help), depth perception - these seem to respond best. Several member report DR being completly fixed ... however it does nothing for this symptom for me (at this time).

Everyone is different. HPPD is complex. While I note your negative reaction to reducing dopamine, I've assumed possible positive results by increasing dopamine. But I am not a doctors and even if I was, you just don't know until you try.

Hope this info helps. Best of success to you...

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Very usefull information. Thank you very much for giving the time. I'm very interested in trying Sinemet.

You mention "I've had bad reactions several times with differents medications but only temporary" - it would be helpful if you would list the meds and what the temp bad reactions for each were.

With almost every medication that I've had problem with, the main issues has always been the DP/DR.

- Cyclobenzaprine: Make my DP/DR worse.

- Fluoxetine: DP/DR more intense and worsen visuals, specially halos around objects and trails. (I left the treatment in the second day)

- Paroxetine: Same as Fluoxetine.

- Ciprofloxacin: Made my DP/DR worse (Left the treatment after the first pill)

- Benadryl: I used it for one day and it made my DP/DR worse.

- Hydroxyzine: This has been the worse one, like starting from the beginning again.

And the following medications has no negative effect on my HPPD:

Venlafaxine: Good for depression, but it causes insomnia.

Trazodone: Great for depression and great for sleep.

Of course; Klonopin: The king. Magic pill. It fixes everything, no matter how bad it this. (Im now tapering off, I’ve been addicted to high doses during many years and I’m in the road of leaving it for ever – Very sad as it has been my best parter)

This is what I can remember at this moment…

Does you doctor(s) recognize you have HPPD?

I haven't even bothered mentioned him. It is supposed that I only have a panic disorder and DP/DR but non drug related (Thats what I tell him) so I can get benzos and this way is much easy. I just pay him and I get the prescription for Klonopin. I've been with different psychs but the truth is that I got tired. First I have to educate them about this disorder. Some believe it, others don't and those who believe it has no idea what to do, and doctors here in my country hate to be told what to do, they really think that they are gods, even when I show them medical literature. ... So doing it this way I avoid some extra stress.

About Sinemet, all the formulations available here come carbidopa 25/ levodopa 250. I don't know what to do about this..

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SSRIs (Fluoxetine, Paroxetine) tend to lower dopamine and many HPPDers don't do well with it. [ Trivia time: There is a serotonin/dopamine balance that is apparent in the circadiam rhythm. ]

Ciprofloxacin does interact with dopamine

Benadryl actually increases serotonin a little bit

Hydroxyzine lowers dopamine and affects acetylcholine [ Note: there is an important ratio between dopamine and acetylcholine ]

Cyclobenzaprine - this one is unclear but it increases norepinephrine (the child of dopamine) and affects acetylcholine

Why you did so well with Venlafaxine and Trazodone is a mystery ... but hey, we all are unique - relish it with pride :D

However with the others, you can see a pattern with your visuals and DP/DR being somehow related to dopamine/acetylcholine - its worth noting anyway ... hopefully it may lead to something useful.

How effective was Klonopin for visuals and DP/DR?

About Sinemet, all the formulations available here come carbidopa 25/ levodopa 250. I don't know what to do about this..

This formula is for advanced Parkinsons (higher dosing) ... but if it is all you can get, you can work with it.

Reason for carbidopa:

Levodopa is used in the body as well as the brain. So if you take it, the high levels cause side-effects ... most notably nausea and increased heart rate.

Carbidopa doesn't do anything useful by itself, but the body will preferentially use it instead of levodopa (its a 'dummy'/decoy). Here is the trick: levodopa can cross the blood-brain barrier (get to the brain) but carbidopa cannot. So carbidopa keeps the body occupied so the levodopa can get into the brain instead of being all used up by the body. The word Sinemet is latin for "without vomiting" ... medium to high doses of levodopa will make you puke ... carbidopa fixes that.

The rule of thumb is to target carbidopa in the range for 75-100mg per day. Hence the 25/100 formulation lets you take lower amounts of levodopa than the 25/250 formula. Clear as mud? :P

The 25/250 will be a little less effective and may have more body symptoms. But you can still work with it, keeping this in mind. You have quite a list of meds that you have tried so far, so you are used to the ups and downs and shouldn't really have much problem. Since I usually only take a daily amount of 37/150 you see that technically I don't get the full carbidopa ... but it works fine.

I fully understand you attitude about doctors. I wish I could just get meds without them. But over the years have found some who work successfully we me. It sounds like you are mostly there too.

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Thanks again.

Well, it's real sad that I can't get the 25/100 formula :wacko: There is like 5 or 6 different brands of generic Sinemet available here and all are the same formula. What a little creativity. Sometimes I think in ordering to an online pharmacy but I don't know if it worth the risk.. Anyway.. I don't know any online pharmacy. I'll see what I can do...

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  • 3 months later...

This is an old post.... Anyway, I just found a formulation of 50/200 (Sinemet XR) and another one with Levodopa 100 / Carbidopa 25 / Entacapone 200, this would be the right one if it wasn't for the Entacapone, which I have no idea what it is. Do you know anything about it? And as I already said, The rest of the formulas are 250/25 here. Any suggest?

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g29 are you better from the initial complaints of this topic?

I think my trails were permanently affected, although I'm not sure, I don't know if I got used to this change. The rest is back to "normal"

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