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Re: Went to pdoc today ... what do you think?

Posted by yxibow on May 2, 2006, at 14:25:06

In reply to Re: Went to pdoc today ... what do you think?, posted by UgottaHaveHope on May 2, 2006, at 12:23:36

> For GAD, I was taking 200mg Seroquel at night, and then 1-2mg Klonopin per day.
>
> She suggested I take 300mg Seroquel at night, and 1-2mg of Klonopin per day. She also wrote me a prescription of 20mg Paxil per day.

There's more than one way to solve or mitigate some psychiatric disorders. She may have a reason for using an atypical antipsychotic. It might not be my first choice for GAD but if it is at least partially working than there is some cause for it. Seroquel is the least likely to cause side effects of them and the least likely for TD. Mainly have to watch your weight (as I do with it) a little bit. Not nearly as bad in that arena as Zyprexa which also has positive benefits but raises lipid profiles differently. Zyprexa may not make you as sleepy as Seroquel but it can give some people major cholesterol problems and myself it gave bad tremors. Otherwise I'd still use it.

Paxil is one of the more sedating SSRIs before Luvox (most sedating), and has a more appealing profile for anxiety than other SSRIs. It does require that you adhere to the dose because the half life isn't as good and coming down off of it requires slow attention. Some people will say that's horrid and I'm sure they've had bad experiences but if you taper properly it shouldn't be as bad an issue. Everything has its tradeoff.

Not increasing the Klonopin instead of the Seroquel -- mm... not quite 6 of one and half a dozen of the other but somewhere inbetween.


> I asked pdoc about Wellbutrin (she said it wouldn't be good for me, or would probably make me more anxious)

If you have anxiety like me but also have some mild depression, Wellbutrin will eventually set your head on fire and cause you to ruminate at night. Its loosely based on a long unused diet drug called Tenuate which is loosely connected to amphetamines.

MAOIs (she said too many restrictions)

Yes, some people on here -- in fact a suprisingly large number -- but I recognize that some people have bad depression and sometimes you hear the worst, take MAOIs. They're dangerous without supervision and attention to detail and don't let people who take them let you think they're candy for the brain. They require a special diet, and pills to keep around in case you have a hypertensive crisis on some kind of cheese (example).


and ENSAM (never heard of it)

She may not be in the most up to date circle. ENSAM is another MAOI but in patch form. It is seligiline, Eldepryl, based in a transdermal absorption package. At low doses it is supposed to be less but not fully restrictive of diet. At higher doses, that is not the case.

. I didn't know if I needed to try those meds, but I thought I would ask.

Leave the MAOIs for when you've been through others. My 2c anyhow. Do you really want to not take cough syrup, sudafed, and various OTC meds?

>
> Thoughts, please?


Tidings

-- Jay

 

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poster:yxibow thread:639045
URL: http://www.dr-bob.org/babble/20060429/msgs/639256.html