Posted by Cam W. on February 12, 2002, at 12:09:44
In reply to Cam, I don't want to impose..., posted by IsoM on February 9, 2002, at 16:29:12
IsoM - It would really depend upon what problem this lady is having with her liver. Also, if the anxiety and liver problems were bad enough I would not worry about sexual dysfunction (or weight gain) if I really wanted relief.
If she were adamant about all of the criteria I would suggest Neurontin™ (gabapentin) as a first med to try. It is not metabolized, but I would not hold my breath in it working. There is a chance it will work, though, but it may take a while (eg. 2 to 3 months would be an adequate trial).
If the anxiety is disturbing her quality of life, I would say try Paxil™ (paroxetine) and side effects be damned (or control them very diligently).
Of course there is always the benzodiazepines, and since liver dysfunction usually means decreased oxidation reactions, you would want to use a benzo that is metabolized through glucuronide conjugation or nitro reduction. Also, you would want to pick one with an intermediate half-life and has no active metabolites. Examples would be Serax™ (oxazepam), Lectopam™ (bromazepam) or perhaps Klonopin™/Rivotril™. I would want to deduce what is causing the anxiety before masking it with a benzo, though.
There are a number of non-drug ways of controlling anxiety, and these would be the safest methods of all. Therapeutic contact, education on the disorder and reduced isolation are ways to start. Relaxation techniques and fprmal psychotherapies (cognitive-behavioral, interpersonal, systematic desensitization, stress inoculation, relaxation training, relationship therapy, etc.) can help more than meds in many situations.
You can forward this to the lady if you like. - Cam
poster:Cam W.
thread:18010
URL: http://www.dr-bob.org/babble/social/20020202/msgs/18127.html