Posted by chemist on October 1, 2004, at 23:27:37
In reply to Hey Chemist or other esteemed member please read, posted by owenus32 on September 28, 2004, at 18:18:14
> Hi,
> I am on lexapro 20 mg , klonopin 1 mg and half of one 250 mg depakote a day. I know that depakote is a "timy" dose but when I came off it I felt really agitated and obsessive and stuff. I'm diagnosed as medium depression, severe gad and mild ocd. Anyway, I think it is that bipolar spectrum because when I take ad's I have to have benzos to calm down and also, when I took Lamictal I felt "normal". It was a profound feeling but unfortunately I got a rash and stopped. Anyway, the depakote seems like it works despite slight confusion it can cause. And it feels like benzos are like taking aspirin for a headache while lamicatl made me feel "normal". So I recently came off depakote and freaked . It's been 10 days and i am far worse off. I don't know if it's just withdrawal anxiety or if I have the mood tging but I think it is the mood thing. ARG, sorry to babble on... anyway I think it's a mood thing. OK, now my big Fear today is that I've been on medication antidepressants for 6 years and benzos like 3 or 4 of that. I'm afarid of what that will do to me, like destroy my ability to reason or live without them. Maybe if I never took them I could be better now through therapy or living. But I'm afraid I can't live without them. Is this because I need it or they have conditioned me to need them by taking them? Please answer
hello there, chemist here...i thank you for your vote of confidence in my abilities to address problems such as yours, and there are many more folks in the know that i. it appears that there are (at least) 2 issues here. first off, the impetus to address whether or not extended treatment with benzodiazepines and antidepressants is detrimental in the long term in re: cognitive function and dependence or perhaps more appropriately conditioning your brain and a few key players therein. in my opinion and experience with antidepressants and anxiolytics, i can state that prolonged exposure to these classes of medications does alter one's mental state: this is my way of stating that even when varying degrees of efficacy have been evident, one cannot dismiss the altered biochemical and neurological parameters. on a fundamental level, flooding synapses with GABA and serotonin will result in some rewiring, so to speak, although my choice of words implies some permanent change. my experience has been that after a spell following discontinuation of an AD or anxiolytic that things return to where they were at the outset. i am unaware of the body of literature concerning long-term effects of either class of medications (with notable exceptions targeted at elderly patients, those with substance abuse troubles, and so forth), and if you have been using ADs of the SSRI and second-generation SSRI/SNRI class, there are likely fewer data because these medications have not been around that long. if anxiolytics are kept in reasonably steady dose ranges and substances like alcohol are avoided, then i see little reason to halt their use if positive. in summary, i am not personally aware of any problems with long-term use of ADs of the classes mentioned by me nor am i aware of dangers of long-term use of anxiolytics - and i do qualify these statements as being largely my opinion and experience and not based on any even moderate basis for backing these thoughts with well-designed and controlled studies. second, you report that mood-stabilizing medications have been very effective, and that your lexapro and klonopin pale in effect to lamictal and depakote. this renders the first point i addressed almost moot, in that you appear to need an anxiolytic when mood-stabilizers are withdrawn and thus the activating effects of the AD are more pronounced. you also report feeling quite out of sorts when the meds targeting mood-stabilization are withdrawn. why not examine, with your doctor's consult, the possibility of lowering the lexapro while introducing perhaps trileptal as an adjunct to (reintroduced) depakote? you could keep the klonopin - a low dose as it stands - on-board and taper if you are comfortable. cognitive effects can be addressed in numerous ways, and medications that are cholinesterase inhibitors might have additional mood-stabilizing effects while addressing the cognitive effects. please do keep us informed, apologies and thanks again....all the best, chemist
poster:chemist
thread:396473
URL: http://www.dr-bob.org/babble/20040927/msgs/398118.html