Posted by Ron Hill on March 25, 2002, at 10:48:07
In reply to Re: Anxiety Meds » Ron Hill, posted by lizzyg on March 25, 2002, at 7:38:04
Lizzy,
Thank you for the update! It sounds like your situation may require bigger guns than SAM-e can bring to the battle. How much SAM-e are you currently taking? Also, it is very important that you take a sublingual (under the tongue) bioactive B-12 (methylcobalamin) vitamin daily (in addition to an oral B-complex). I take a 1000 mcg sublingual tablet twice a day. Although I do not suffer from anxiety to the extent that you do, I can report that as I hold the B-12 under my tongue, I experience a very noticeable calming, peaceful effect. Are you taking a sublingual bioactive B-12? If so, how much and what biochemical compound is it?
With regard to which AD to try if it turns out that SAM-e/B-vitamins will not abate your anxiety, I agree with you that Serzone would be a good choice to try first. As you know, in the lower dose range Serzone treats anxiety and in the higher dose range it is an effective AD. Personally, I would NOT take Effexor (venlafaxine) because, as you know, in the higher dose range it is an SNRI and, for me, an increase in norephrinepine will increase anxiety. But that's just me, and your mileage may vary.
Using Neurontin (gabapentin) to treat anxiety in a unipolar, such as your self, would probably be considered as a second line approach by most pdocs (and pbabblers). As a bipolar, I've been looking at Neurontin for more than a year for possible use as an add-on to my Lithobid. Neurontin has a fairly benign side effect profile (which is important to me) and the GABA effects might help my slight GAD symptoms. But I'm not going to change anything for a long while because I WILL NOT risk screwing up my current EXCELLENT combo (600 mg/day Lithobid and 200 mg/day SAM-e). Ask JohnX2 and others your AD questions. John takes Serzone so he would be a good one to ask.
Do you plan to continue to use SAM-e/B-vitamins as an add-on if you begin your Serzone trial? That's what I would do.
-- Ron
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> Hi Ron - I probably confused you because I was having a little joke with Colin about how under-informed our British GPs are about depression and anxiety medications.
>
> I think my diagnosis would fall into the category of 'classic' endogenous major depression, with associated anxiety. At the moment, I'm only taking SAM-e and it HAS had an anti-depressant effect, but I would say not as good as previous treatment with tricyclics (I can't tolerate SSRIs). However, with the tricyclics I found the anxiety diminished along with the depression, but this hasn't been the case (so far) with the SAM-e.
>
> Benzos have worked fine in the past for treating the anxiety which has gone hand in hand with the depression, but it's only been short-term usage until the ADs kicked in properly. And the British medical establishment seem completely paranoid about benzos and will only really prescribe for a couple of weeks. So I don't think benzos would be a long-term solution for the anxiety. I don't know about gabapentin (Neurontin), so will do some reading up about that.
>
> Like you, Ron, I find exercise a life-saver and try to swim three times a week, which helps with both the depression and the anxiety.
>
> I'm loath to give up on the SAM-e so will give it a while longer. If there's no improvement on the anxiety, I think I'll probably have to try a prescription AD again. I'm thinking Nefazodone/Serzone would probably be high on the list of options (Mirtazapine/Remeron was too sedating for me) although my GP seems to be pushing Venlafaxine. Any views?
>
> Thanks
>
> Lizzy
poster:Ron Hill
thread:98301
URL: http://www.dr-bob.org/babble/20020322/msgs/100029.html