Posted by MB on January 1, 2002, at 15:22:34
In reply to Re: GABITRIL (tiagabine) new anti-anxiety drug????? » MB, posted by Mitch on December 30, 2001, at 22:11:15
> > Yeah, Maybe the benzo/AE/pstim (Klonopin/Neurontin/Adderall) would work to fix cylcing, anxiety and attention problems...but you did mention that your anxiety was "OCD-like" for which an SSRI might do better than Klonopin (but, like you said, you risk cycling with the SSRI). Neurontin/pstim/Li? Does the lithium have an anti-anxiety effect for you? Would the weight gain issue with litium worry you?
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> Yes, the Lithium does have something of an anxiolytic effect. I was on lithium monotherapy for many years. It is just during the seasonal depressions I would get so tired... and the lithium didn't address that very well. Not that I ever wasn't at "high-enough" doses. I was up to 1500mg/day for a few months (about 1.2 blood level-wise). I never found more than 600mg/day to be of any additional benefit. I never experienced any major weight gain from Lithium. Depakote was a different story, though (but that was still about 15-20lbs. at most).
I'm pretty obsessive about not gaining weight. 20 lbs would freak me out. When you gained weight on the Depakote, was it because the Depakote made you hungrier? I gained 20 lbs on Paxil, but I was exercising and eating the same amount of food. That freaked me out (I wasn't over eating and I still got fat).
> As far as the "OCD-like" quality to anxiety-I really think it would be more accurate to say it was GAD-like "ruminations". The "OCD-likeness" of it had mostly to do with the repetitive (and "stuck") aspect of it. I don't *do* rituals (checking-counting, etc.)-I would obsessively worry about situations-what I said-what was said in return-what I plan to say later-like a negative rehearsal of sorts-a waste of time that just makes you feel crappy. Also, a lot of "catastrophic thinking" which is typical of people with GAD. But, I don't feel uncomfortable looking at it as related to OCD-because I think it is.
What you described is EXACTLY the kind of ruminating I go through. I *do* have a few weird rituals, though. For example, after I flush the toilet, I can't be standing on tile (I have to be standing on carpet) when the toilet is finished filling back up. This is a modification of one I've had since third grade: I had to be in bed and under the covers before the bathtub was done draining or it meant I'd have to sell my soul to Satan. Now where in the hell did a third grader come up with *that* one? Pretty bizzare. As I've gotten older, the rituals have gotten fewer, but the ruminating (e.g., having fight in my head with people that I plan to see later that day, etc.) hasn't changed and it reminds me exactly of what you described above.
> > Journaling or charting is hard for me. First of all, focussing is hard, and then, when I *do* focus, I obsess over the perfection of the chart...as if a mistake is going to be the end of the world. For now, my poor friends can be my journal. I babble at manic length about where my mind is and what meds I'm on...then I ask them later what I said. Very inaccurate, but if they make a mistake I can get mad at them instead of myself < g > heh heh heh...
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> Yep, you have got that "stuck switch" situation that SSri's help. It is interesting that people with ADD hyper-focus and get "stuck" like folks with OCD (getting fussy and perfectionistic). Also social anxiety is related to perfectionism, too (evaluation anxiety). I am starting to see this type of symptom complex emerge the more I read and post here-this blend of bipolar, SP, ADHD, OCD/GAD. I am just hypothesizing here, but I think (my opinion!), this is all an information processing problem that involves major structures in the brain simultaneously underfunctioning and overfunctioning. I think at bottom it results in some form of an "attentional syndrome" that can manifest as over-focusing (GAD/OCD/SP), and also a lack of focus (BP, ADHD). The negative emotional "fallout" is a result of screwed-up information sharing between different functional and structural parts of the brain.
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> > Yeah, I though Trileptal was screwing with my concentration, but it was the caffeine withdrawal. I ran into a stressful social situation (resulting in a 4 hr drive) so I slipped off of the coffee wagon . The concentration returned (but so did the anxiety). I start my caffeine detox again tomorrow so I can enjoy the leveling effects of trileptal without the caffeine anxiety. On the trileptal, my chronic negativity and cynicism are gone (only at 150 mg), but there is still a painful dysphoria. I guess the AD and pstim will help with that. Amphetamine still seems scary to me. Did you find Adderall addictive at therapeutic doses? I was addicted to crank as a kid. I told my doctor that (that I was scared) and he said that at therapeutic doses I wouldn't be getting "high" and would have no desire to abuse it. Do you think that is true?
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> > MB
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> Well, I was only on Adderall for a couple of months. It was very effective-and at only 5mg/day. I never wanted to take more of it. I got a little euphoric the first day or two on it-then I was just alert and slept ok. As far as abuse goes-all you can do is try it and see. If you find that you are focused and alert and still want to take *more* to get a buzz-then that would probably be a danger sign. I never liked "speed" that much. If I was going to get "addicted" to something, opiates would be the most likely thing for me (I "liked" pain killers after surgery-etc. probably a little *too* much).
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> Mitch
Yeah, I figure the first few days I'll give the Adderall to a friend and have them give me my doses so if I *do* get a craving to use more I won't me able to. This is what I have to do with Vicodin when I get hurt. Last time I was in charge of my own Vicodin I went through 20 in a 24 hr period. I wonder how addictive personality fits into this strange spectrum of mood/attention/obsession problems. The more I hang out here, the more it seems these things are not discrete disorders, but inextricably related in some fashion.MB
poster:MB
thread:86944
URL: http://www.dr-bob.org/babble/20011222/msgs/88460.html