This probably isn’t the right time to write this, since I’m flying on dex (dexamethasone) at the moment. On the other hand, there’s nothing like a dose of dex to make one remember what the problems are. I believe every dex prescription should be accompanied by a psych referral. I have been fortunate in that regard. Here is a list with the chemical warfare agents I use in battle:

1. Sleeplessness.  I know of only one drug that will safely put me to sleep at a reasonable hour, and that’s an anti-psychotic named Seroquel. The smallest dose available is a 25mg tablet. I take it at about 8pm. By 9 I’m getting a touch of restless leg syndrome, but that passes by 10. Then I feel sleepy. At 10:30 I drop like a stone. If that isn’t enough, I double it. The highest dose tablet available of Seroquel is 300mg–and I can’t even imagine how crazy someone would have to be tolerate a dose that large. Those of us reacting to dex would never need anything nearly that huge. In fact, when not on dex, 12.5mg is too much for me. To give you an idea of how small a dose I’m talking about, the max daily dose in the PDR is 800mg/day. At the lowest doses, I’m a little groggy in the morning. I think the way it works is to fix it so that I can’t remember whatever I may have been upset about–until it wears off.

2. The Shakes.  Sometimes my hands shake, and I tend to get super clumsy, knocking at least one thing over for everything I try to pick up. The best remedy I know about is Librium, a very old tranquilizer. It seems to stop the physical manifestations of agitation. I use 10mg tabs, again the smallest available. If after an hour I’m still agitated, I drop another 10mg. I’ve never needed 30. Like Seroquel, it’s a relatively safe drug that crazy people can tolerate at extremely high doses, so, once again, this is a very tiny dose.

3. Gastric Distress. For that, Prilosec. Not Nexium, that’s a marketing ploy. One pill at bedtime. I also have alka seltzer tablets around just in case, as well as pepto-bismol. The latter two are really handy when it hits fast and ugly. Tagamet too.

4. The ups and downs.  Dex in some order or another makes most of us hyper and high, or inert and depressed, depending upon the cycle. Depakote (250mg tablets) seems to be effective at lowering the highs and putting a floor over the lows. I start it the day before dex (one tablet), then two a day during dex pulses, and for a few days afterwards. If it’s a really bad day, a third tablet has always worked for me. The recommended initial dose in the book is 750mg/day and dosing can go a lot higher, but for us are high.

5. Longer-Term Depression. Wellbutrin 300XR seems to have fewer sexual side effects than most anti-depressants and is as effective as any of the others in general, your mileage may vary. Take once pill once a day.

6. Thrush. Gargle with 50/50 water and peroxide. Chlorhexadine may also be helpful.

7. Painful knots in hands or feet. Dex blows away my sugar levels, making my hands seize up like a spider. Thermotabs (salt) by mouth may help. If you can’t find them, just mix salt in water and drink it down. Quinine in low doses may also be helpful, but as Kathleen is sure to point out, it can cause serious renal problems. However, it is commonly prescribed for muscles jerking.

8. Judgment. Don’t drive! The horror stories are real and frequent.

9. Other Psych Problems. Whatever incipient problems a person has, dex tends to stimulate them. Pre-psychotics will break. Compulsives will turn pro. In my case, Luvox helps to fight compulsions. If you or your keepers feel you’re losing your mind, for heaven’s sake, see a shrink.

10. Don’t have a ten, so good luck and please report errors in the above (since I’m stoned) or alternatives that have worked for you.

Lon

Lon Nesseler