Posted by Thrud on August 24, 2001, at 2:30:28
In reply to Re: Xanax and panic, Elisabeth, more. » Thrud, posted by Rick on August 24, 2001, at 1:32:59
> You shouldn't be too quick to dump the Xanax without giving yourself time to adjust to the side effects, and perhaps even finding that you can lower the dosage without losing benefit.
True. Could you give me some idea how long I should wait? Especially with regards to the sexual dysfunction effects I am getting with Xanax.
> While it varies greatly by individual, many find that Klonopin works a lot better as an ongoing treatment for panic than Xanax, and at lower equivalized doses with less fatigue. That's certainly true for loads of people who post here. It is longer acting and thus doesn't need to be taken as often. If you check Medline you'll see other benefits as well.
Please excuse my naivite. Is that Medline.com or something?
If the Xanax doesn't work out, you should *definitely* give Klonopin a try. (It's the mainstay of my social phobia treatment. It actually *increases* my libido at a moderate dose, but I'm not sure that's typical.)
I have read about that effect. That would be awesome! At the moment my pdoc is firmly focused on Xanax because of it's antidepressant properties. However, if I could be panic free, have an unaffected libido and not feel like sleeping all day, there would be NO depression, I guarrantee that!
> Getting back to short-acting benzos, some people respond better to Ativan than they do to Xanax.I've heard it called a "watered down" version: less side effects but less powerful. Is this a widely held view?
> Benzos are the gold standard for panic -- even if many docs remain benzophobic -- but there are other alternatives besides SSRI's.I am lucky I have a pdoc who believes in benzos: at least he's willing to give them a try!
> The reversible (no food restrictions) MAOI moclobemide has shown success in many panic disorder studies (with and without comorbid depression). It has about the lowest incidence of sexual dysfunction of all the AD's.
Used it ages ago (for a about a year). Not very good for my panic, still left me with some significant sexual dysfunction. (getting the idea I am a hardcase ???)
> Serzone, while having a somewhat lower success rate for panic than the SSRI's, works very well for many people. It has a very low incidence of drug-induced sexual dysfuntion (I take it with the Klonopin with no problems in that regard), but at the highest doses it can have a sexually inhibiting effect in some. Many people find it quite sedating, although some don't. You just never know...Tried that too. Once it gave me significant sexual dysfunction, I ditched it!
> I've heard a few reports of Remeron efficacy in panic. It has a lower incidence of sexual dysfuntion than SSRI's, but not as low as Serzone. It tends to be even more sedating than Serzone, and has a reputation for inducing weight gain.I found all the above to be true. However, if it did not give me sexual syfunction I would have persisted with it.
> On the OTC front, some panic specialists find that Taurine supplementation is all that is needed for some patients. (Taurine is an amino acid, one of the ingredients in Red Bull -- not that I'm suggesting you use Red Bull!)
>
What Taurine about co-morbid depression?
> Finally, several Israeli studies found that mega-doses of Inositol (a B vitamin) work as well as SSRI's in panic (and OCD), without side effects. See Medline.I am very interested in this stuff. I think I will buy some and see what happens.
> Good luck, and please read the following article on panic, which was posted here a couple months ago by another individual. It's fabulous information (much of it applicable to *any* anxiety disorder), even though I do disagree with the author on a couple of points. It points out how benzos are generally most efective longterm in PD, yet high-powered pharmaceutical company marketing, and benzophobia in the medical community cause PD sufferers to end up with (usually) inferior and side-effect-laden SSRI treatment instead.
>
> http://bearpaw8.tripod.com/pd.htmlI have read it and was extremely impressed. After reading it I virtually demanded my pdoc try me on Xanax! Before that we were experiementing with the mega$$$$ Lamictal.
After being on 3mg Xanax/day for about 2 weeks I am now up to 6mg/day. These are my problems so far:
1) very significsant lack of libido
2) depressed
3) always sleeping
4) poor co-ordination (I don't like to drive at the moment)On the plus side:
1) My anxiety sympotms are way down and panic non existentAny indication how long I must endure before the "bad" list before it subsides? I am under the impression that as part of the tolerance-dependence process the bad list tends to subside.
Any personal experiences from yourself or aquaintances on this "running in" period would be most greatly appreciate it.I really appreciate the time you took to consider my case. I hope you respond and eeducte me some more!
Thrud
poster:Thrud
thread:76063
URL: http://www.dr-bob.org/babble/20010822/msgs/76200.html