![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 197 to 221 of 251. Go back in thread:
Posted by JCB on June 24, 2001, at 12:08:44
In reply to Re: Addictive meds in general, posted by gilbert on June 24, 2001, at 11:59:59
I never thought of it that way, but you're absolutely right. What else can I say :-) Thanks for enlightening me to this latent relationship.
Posted by Zo on June 24, 2001, at 15:55:33
In reply to mood disorders/klonopin,depakote,neurontin etc...., posted by paul on November 26, 1998, at 8:21:48
. . as depakote, or Klonopin. It is not addictive, or habit-forming, and while no med can be ruled out as having a negative effect on someone, Neurontin works for many conditions such as anxiety, TLE and pain by caliming the excitable GABA receptor sites. Altho it was hell to get on and ramp up, because of daytime fogginess, it has been nothing but beneficial to me, and is remarkably non-toxic. No comparison to other anticonvulsants, which can be nasty buggers.
Posted by Elizabeth on June 25, 2001, at 2:50:07
In reply to Addictive meds in general, posted by JCB on June 22, 2001, at 0:58:18
The term "addiction" is confusing. This is due, in part, to changing definitions. Twenty years ago, any drug that had a characteristic withdrawal syndrome was considered "addictive," and people who took such drugs (regardless of how they took them) were uniformly considered "drug addicts." It was a relatively simplistic and objective definition.
Today, "addiction" refers to the psychological disorder classified as "substance dependence" in DSM-IV. The tolerance/withdrawal syndrome is more properly identified as "pharmacologic dependence." It is not a disease, but a normal response to taking drugs for a long enough period of time. It is recognised that people who take drugs that have virtually no abuse potential (including many antidepressants) do often experience withdrawal symptoms if they discontinue the drug abruptly or miss a dose. This phenomenon, it is recognised, is not properly considered to be a drug addiction, and people who use antidepressants, anticonvulsants (including benzodiazepines), certain cardiac drugs, stimulants, glucocorticoids, opioids, etc., on a daily basis are not automatically classified as "drug addicts." It is understood that these drugs can and are used in a nonpathological way in the treatment of such conditions as depression, bipolar disorder, anxiety disorders, chronic pain, hypertension, tremor, attention deficit disorder, narcolepsy and some other sleep disorders, inflammatory conditions, autoimmune diseases, organ transplantation, etc.
The realisation that many classes of drugs thought to be virtually free of abuse potential -- such as SSRIs, tricyclics, MAOIs, centrally-acting alpha-adrenergic agonists, glucocorticoids, and anticonvulsants other than barbiturates and benzodiazepines -- can cause characteristic withdrawal syndromes and/or rebound symptoms is clinically important, because it is extremely important that these drugs be abruptly only in emergencies.
The distinction between true addiction and pharmacologic dependence is also important because "addiction" is such a loaded word today. Most people who take benzodiazepines for anxiety, stimulants for ADHD or narcolepsy, opioids for pain, etc., do *NOT* become drug addicts. Withdrawal symptoms are normal responses to discontinuation of these drugs, just as it should not surprise a pdoc (or other medical professional or counselor) if a person suffers withdrawal symptoms when he or she tries to stop taking Paxil or Effexor.
It is incorrect and misleading to label a person a "drug addict" based solely upon the manifestation of the substance-specific withdrawal syndrome upon discontinuation of the drug. Although most addicts do suffer withdrawal symptoms, there is much more to addiction than that.
Although I don't generally think that the DSM-IV definitions of mental disorders are very useful or precise, the definitions of substance dependence and substance abuse are worth careful examination -- *especially* by mental health professionals. A MHP who is unaware of the difference between true addiction and pharmacologic dependence runs the risk of placing people in "treatment" programs which will, at best, be of no benefit; indeed, the stigmatising label of "addict" may be harmful to these people in many cases.
It might be of interest that a standard medical school pharmacology textbook (Goodman & Gilman's _Pharmacological Basis of Therapeutics_) recommends doing away with the word "addiction" altogether because of its pejorative connotations and the confusion surrounding its meaning.
-elizabeth
Posted by Elizabeth on June 25, 2001, at 3:30:29
In reply to Re: Addictive meds in general, posted by gilbert on June 22, 2001, at 10:30:37
Gil,
Like you, most people taking doses within the accepted therapeutic range can taper off benzos without suffering significant withdrawal symptoms. With appropriately cautious tapering, seizures are almost unheard of. The discontinuation process often has to be an extremely slow one, though, especially with short-acting benzos such as Xanax or if the person has been taking the benzos for a very long time.
I've encountered 12-steppers who express the sort of attitude you mention, that the use of benzodiazepines (or even, sometimes, of antidepressants!) jeopardises the sobriety of a recovering addict. Although addiction history should be considered, my own opinion is that alcoholism and other addictions should *never* be seen as absolute contraindications for the use of benzos in the treatment of anxiety disorders.
Although people who are currently abusing other drugs are the most likely to abuse prescribed benzos (otherwise, abuse is almost unheard of), many people originally *became* addicts (alcoholics in particular) when they realised that they could use drugs to "self-medicate" lifelong anxiety disorders. Denying these people BZDs may actually put them at *increased* risk of relapse. Such patients should be carefully monitored, of course, but benzos are extremely safe and effective for anxiety, while alcohol carries all sorts of health risks as well as the general risk of addiction associated with unmonitored self-medication.
SSRIs have been touted for anxiety disorders, but many anxiety patients find the side effects *very* hard to tolerate. Benzos, in contrast, are almost invariably well-tolerated. Personally I have never experienced any adverse side effects from my intermittent use of benzos or for the month or so that I took Klonopin daily.)
> I also have never wanted to take them to get high in fact I don't feel high at all from taking them...they just get rid of the panics and make me feel normal.
Same here. I have a hard time believing that *anyone* would find benzos a "high." I suspect that, more often, people who use unprescribed benzos are using them to stave off withdrawal symptoms from other drugs such as heroin and alcohol.
> Even though tolerance may appear after the initial dose most people can maintenace dose with the same amount year after year.
Tolerance to the anxiolytic effects is the exception, not the rule, with benzos. (People do grow tolerant to side effects like sedation, dizziness, and appetite stimulation, though.)
> I will tell you all drugs cause dependence at some level.
Yes, this is just what I was getting at ("physical" or "pharmacologic" dependence). Unfortunately, even many mental health professionals do not understand the difference. As a result, many non-drug-abusing anxiety patients are pressured to stop taking benzos, and some are even pushed into "rehab" programs where they don't belong at all!
> Even blood pressure drug removal causes rebound.
Very true. Clonidine, an antihypertensive often used for ADD-associated hyperactivity, is particularly notorious for this (something which child psychiatrists too often fail to mention to the parents!). People who take glucocorticoids (cortisol-like steroids such as prednisone, dexamethasone, etc.) can suffer severe, even fatal, withdrawal reactions if the drug is suddenly discontinued. And benzos and barbiturates aren't the only anticonvulsants that can cause rebound seizures; all anticonvulsants have this potential (which makes me rather concerned about the extremely liberal use of these drugs in off-label conditions).
> I have never thought wow why don't I take a bunch of xanax and go hang out downtown and party. They just don't feel or work that way. I have been able to take xanax and do things I was always afraid to do ....
I know exactly what you mean; buprenorphine is similar for me. When used responsibly, these two drugs (which generally have low potentials for abuse anyway) are, as you say, life-savers. There are many people out there like us who can function on a day-to-day basis because of these medications.
-elizabeth
Posted by Annabelle on June 25, 2001, at 5:37:57
In reply to Re: Addictive meds » JCB, posted by Elizabeth on June 25, 2001, at 2:50:07
> The term "addiction" is confusing. This is due, in part, to changing definitions. Twenty years ago, any drug that had a characteristic withdrawal syndrome was considered "addictive," and people who took such drugs (regardless of how they took them) were uniformly considered "drug addicts." It was a relatively simplistic and objective definition.
Thank you for your voice of WISDOM. I think I mentioned this, but my Dad, who is 91 does not want to take any sleeping meds, even though he has a life-long history of sleep problems (which my brother and I seem to have also)because he does not want to become ADDICTED! Dad also suffers from life long depression. In the 40s and 50s whenever he had some Benezedrine he felt better. He begged the family MD to let him have some 'only for when he felt 'lousey and down'', but that was looked upon as ADDICTIVE. He was born before the days of AntiD's, but if the doctors had let him have small doses of Benezedrine, I believe it would have made a great difference in his life, and our entire family.
Annie
Posted by Elizabeth on June 25, 2001, at 6:01:08
In reply to NEURONTIN is not in the same class. . ., posted by Zo on June 24, 2001, at 15:55:33
> . . as depakote, or Klonopin. It is not addictive, or habit-forming, and while no med can be ruled out as having a negative effect on someone, Neurontin works for many conditions such as anxiety, TLE and pain by caliming the excitable GABA receptor sites.
GABA is an *inhibitory* (not excitatory) neurotransmitter, so drugs that activate GABA receptors, inhibit the metabolism of GABA (e.g., Nardil and vigabatrin), block the GABA transporter (e.g., tiagabine), or potentiate the effects of endogenous GABA (e.g., benzodiazepines), cause *decreased* firing and CNS depression (*not* the same thing as "depressed mood"). This is thought to be the basis for their efficacy in the treatment of seizures, anxiety, and mania.
Neurontin's molecular structure resembles that of GABA, so it was natural for researchers to hypothesise that it might produce its effects through GABA-ergic actions. Last I checked, though, nobody had been able to figure out what the stuff does. It is not a GABA-A agonist or a promotor of GABA release. Some research suggests that it may be an agonist at certain GABA-B receptors, however. Another possibility is that it increases GABA activity and/or decreases glutamate activity via enzyme induction. It does seem to alter GABA turnover, a property shared by some other anxiolytic drugs.
Interestingly, I found that Neurontin actually *felt* sort of like Xanax, although it was not as effective for panic disorder. (I probably didn't try a high enough dose; since I didn't have problems with sedation, I've considered giving it another try.) It's not clear whether Neurontin is as effective for anxiety as the benzos are, but there are some studies and anecdotal reports suggesting that it may be worth trying for sufferers of anxiety or mixed anxiety/mood disorders.
> Altho it was hell to get on and ramp up, because of daytime fogginess, it has been nothing but beneficial to me, and is remarkably non-toxic. No comparison to other anticonvulsants, which can be nasty buggers.
Lamictal, which has gained some popularity as an antidepressant-anticonvulsant for people with bipolar-spectrum disorders, is also pretty much free of side effects (and usually isn't sedating the way that Neurontin can be for some people). Lamictal might be a better first choice for people whose problems are more associated with depression or mood swings, while Neurontin may be preferable for those with major anxiety disorders.
-elizabeth
Posted by gilbert on June 25, 2001, at 20:00:18
In reply to Re: Neurontin » Zo, posted by Elizabeth on June 25, 2001, at 6:01:08
Hi Elizabeth..........welcome back,
I have found xanax to have less side effects and to be more stable for panic than nerontin. I know some are getting good effetcs fromnerontin though.Gil.
Posted by Elizabeth on June 27, 2001, at 6:00:12
In reply to welcome back, posted by gilbert on June 25, 2001, at 20:00:18
> Hi Elizabeth..........welcome back,
Hi to you. I'm glad to be back.
> I have found xanax to have less side effects and to be more stable for panic than nerontin. I know some are getting good effetcs fromnerontin though.
That's about what I would expect. I don't have very frequent attacks (since I take ADs), and Neurontin seemed to do some good. It ended up not being worth it because it didn't help with the depression (the real tough problem for me) and I was getting the munchies a lot on it. (I had a real problem with weight gain on Nardil and don't want to repeat that.)
-elizabeth
Posted by Zo on June 28, 2001, at 1:46:20
In reply to Re: Neurontin » Zo, posted by Elizabeth on June 25, 2001, at 6:01:08
> Lamictal, which has gained some popularity as an antidepressant-anticonvulsant for people with bipolar-spectrum disorders, is also pretty much free of side effects (and usually isn't sedating the way that Neurontin can be for some people). Lamictal might be a better first choice for people whose problems are more associated with depression or mood swings, while Neurontin may be preferable for those with major anxiety disorders.
>What these drugs have in common, and what Bipolar, TLE (which I have) and certain other conditions have in common, and what Neurontin seems to "de-excite" is the interest effect of Kindling. It has also been of significant, life-changing help with my CFS / muscle pain / Stage 4 sleep.
Lamactil, interestingly, did not "feel" the same way at all, subjectively, and I never was able to find a good dose. . . for me, it wasn't tolerable.
Neurontin *can*, despite what you may have heard, be taken all at bed. Taken this way, I have no sedation during the day. . and have no break-thru pain or TLE.
Zo
Posted by Annabelle on June 28, 2001, at 8:40:32
In reply to Re: Neurontin, posted by Zo on June 28, 2001, at 1:46:20
> >
It has also been of significant, life-changing help with my CFS / muscle pain / Stage 4 sleep.
>
Taken this way, I have no sedation during the day. . and have no break-thru pain or TLE.Zo....read this with interest as I have chronic muscle spasm in Trap, and occassional muscle pain all over. I have been taking Klonopin and recently Neurontin. Did Neurontin work with your muscle pain?? What dose??? Neurontin worked with my pain for a couple of months. Actually this spasm has been getting worse and the only thing that will calm it down is Klonopin. So...I only take .5, but it makes me so tired. I need to call my prescribing Psych Nurse to see what else I can do. My Neuroligist is scheduling a visit to the Pain Clinic for perhaps a Botox shot, but that could take months.
AM I REPEATING MYSELF???? I think I babbled all of this stuff before, BUT I am interested in hearing from anyone with muscle pain.
Annie
Posted by Zo on June 28, 2001, at 19:27:36
In reply to Re: Neurontin » Zo, posted by Annabelle on June 28, 2001, at 8:40:32
No exaggeration, Neurontin took care of my muscle pain and spasms, of 18-year duration (CFS.)
What dose are you on? I was on Neurontin-L, and while I maxxed out at 900 mg, and am now down to 600 at bed, there were people with severe FM pain taking in the 2,000-3,000 range.
Zo
Posted by Annabelle on June 28, 2001, at 19:50:49
In reply to Re: Neurontin » Zo, posted by Annabelle on June 28, 2001, at 8:40:32
Zo, Wow, that is a high dose. The pain just stinks doesn't it? And you suffered with it for 18 years???.... I am only on 600 in the a.m. and 600 in the p.m. So I might try all at once at night and see if that works. Everything was working for a while, but with age and more wear and tear on the crooked old neck no wonder it is getting worse.
Thanks for all your help... I really appreciate your input to this 'babble'.
Annie
Posted by Lorraine on June 28, 2001, at 20:14:22
In reply to Re: Neurontin, posted by Annabelle on June 28, 2001, at 19:50:49
I'm not the expert on these things, but I think I remember reading here that with Neurontin the body cannot use more than 600mg at a time--hence the split dose.
Posted by Alan on June 28, 2001, at 23:56:22
In reply to Re: Addictive meds, posted by Annabelle on June 25, 2001, at 5:37:57
Thank you for your wonderful insights regarding benzos and "addiction". You have the talents of a writer AND a doc kind of rolled into one. It's so refreshing. Are you either? I'm kind of new here and enjoy your insights and command of the science too.
What is your take on those that suffer chronic anxiety disorders and have been on a benzo to treat for periods of perhaps 10 or more years?
Do you feel that long term constant treatment with no escalation has any downside, even if there are no plans to discontinue and efficacy has been proven?Also, have you ever heard of mediating the effect of fluctuating levels of a shorter acting benzo through the use of acheiving a steady state (lower) dose of Neurontin? How would this make sense - or not - in light of complaints of interdose withdrawls?
Looking forward to hearing from you!
Best,
Alan
Posted by Alan on June 29, 2001, at 0:00:07
In reply to Re: Addictive meds }} Elizabeth, posted by Alan on June 28, 2001, at 23:56:22
Sorry for asking but,
How does one get the "TO" abbreviation that looks like }} ? What key do you hit?
Thanks,
Alan
Posted by Elizabeth on June 30, 2001, at 0:02:55
In reply to Re: Addictive meds }} Elizabeth, posted by Alan on June 28, 2001, at 23:56:22
Alan,
Thank you for your compliments. They are much appreciated.
> What is your take on those that suffer chronic anxiety disorders and have been on a benzo to treat for periods of perhaps 10 or more years?
> Do you feel that long term constant treatment with no escalation has any downside, even if there are no plans to discontinue and efficacy has been proven?No. Some people do develop (or perhaps, come to notice) cognitive problems with long-term benzo use, and in this case it may be better to taper off the benzo gradually. The scenario you've described is not uncommon, and there is no good reason for going off a drug that continues to work and is well tolerated, especially when going off it has the potential to be seriously disruptive (and discontinuing benzos, especially after long-term use, can be very disruptive, not only because withdrawal symptoms are to be expected, but also simply because the anxiety disorder will return).
> Also, have you ever heard of mediating the effect of fluctuating levels of a shorter acting benzo through the use of acheiving a steady state (lower) dose of Neurontin? How would this make sense - or not - in light of complaints of interdose withdrawls?
I would think it would make sense to switch to a longer-acting benzo. Klonopin and Tranxene are my favourites. Neurontin is relatively short-acting itself.
BTW, to get " > > Elizabeth" in the title of your reply, just check the "add name of previous poster" box under the Subject: line.
best,
-elizabeth
Posted by Alan on June 30, 2001, at 1:00:55
In reply to Re: Addictive meds » Alan, posted by Elizabeth on June 30, 2001, at 0:02:55
> Alan,
>
> Thank you for your compliments. They are much appreciated.
>
> > What is your take on those that suffer chronic anxiety disorders and have been on a benzo to treat for periods of perhaps 10 or more years?
> > Do you feel that long term constant treatment with no escalation has any downside, even if there are no plans to discontinue and efficacy has been proven?
>
> No. Some people do develop (or perhaps, come to notice) cognitive problems with long-term benzo use, and in this case it may be better to taper off the benzo gradually. The scenario you've described is not uncommon, and there is no good reason for going off a drug that continues to work and is well tolerated, especially when going off it has the potential to be seriously disruptive (and discontinuing benzos, especially after long-term use, can be very disruptive, not only because withdrawal symptoms are to be expected, but also simply because the anxiety disorder will return).
>
> > Also, have you ever heard of mediating the effect of fluctuating levels of a shorter acting benzo through the use of acheiving a steady state (lower) dose of Neurontin? How would this make sense - or not - in light of complaints of interdose withdrawls?
>
> I would think it would make sense to switch to a longer-acting benzo. Klonopin and Tranxene are my favourites. Neurontin is relatively short-acting itself.
>
> BTW, to get " > > Elizabeth" in the title of your reply, just check the "add name of previous poster" box under the Subject: line.
>
> best,
> -elizabeth
*******************************************
Thanks elizabeth -The partial problem is that the shorter acting Ativan is needed at about 5 MGS on only 3 - 4 days per week for performance anxiety (eves.)while the other days it would be too much.
To keep from being overmedicated on the other days, only 3 MGS are needed. This is where the Nurontin comes in to mediate.
The klon. is too long acting and causes clumsiness anyway at the dosage to be effective in my kind of work and I would feel terribly hung over at the dosage for "off" days compared to "on" days.
It's kind of a special social anxiety subcatagory that I have not been able to treat any other way.
Are there any other ways to treat under these special circumstances that I've outlined or do you think the idea of a mood stabiliser is as good as any that might come to mind?
Best,
Alan (a fellow Chicagoan!)
Thanks for the tip thing.
Posted by Lorraine on June 30, 2001, at 11:09:31
In reply to Re: Addictive meds » Elizabeth, posted by Alan on June 30, 2001, at 1:00:55
>
> Thanks elizabeth -
>
> The partial problem is that the shorter acting Ativan is needed at about 5 MGS on only 3 - 4 days per week for performance anxiety (eves.)while the other days it would be too much.
>
> To keep from being overmedicated on the other days, only 3 MGS are needed. This is where the Nurontin comes in to mediate.
>
> The klon. is too long acting and causes clumsiness anyway at the dosage to be effective in my kind of work and I would feel terribly hung over at the dosage for "off" days compared to "on" days.
>
> It's kind of a special social anxiety subcatagory that I have not been able to treat any other way.
>
> Are there any other ways to treat under these special circumstances that I've outlined or do you think the idea of a mood stabiliser is as good as any that might come to mind?
*********************************************
What about beta blockers, Alan? I think that performers use these a lot for performance anxiety.
Posted by Alan on June 30, 2001, at 15:05:49
In reply to Re: Addictive meds, posted by Lorraine on June 30, 2001, at 11:09:31
> >
> > Thanks elizabeth -
> >
> > The partial problem is that the shorter acting Ativan is needed at about 5 MGS on only 3 - 4 days per week for performance anxiety (eves.)while the other days it would be too much.
> >
> > To keep from being overmedicated on the other days, only 3 MGS are needed. This is where the Nurontin comes in to mediate.
> >
> > The klon. is too long acting and causes clumsiness anyway at the dosage to be effective in my kind of work and I would feel terribly hung over at the dosage for "off" days compared to "on" days.
> >
> > It's kind of a special social anxiety subcatagory that I have not been able to treat any other way.
> >
> > Are there any other ways to treat under these special circumstances that I've outlined or do you think the idea of a mood stabiliser is as good as any that might come to mind?
> *********************************************
> What about beta blockers, Alan? I think that performers use these a lot for performance anxiety.
*******************************************
Yes, I do use them but they only take care of some of the physiological symptoms and not the psychological ones. Thanks for the good suggestion though!Best,
Alan
Posted by Elizabeth on June 30, 2001, at 17:47:37
In reply to Re: Addictive meds » Elizabeth, posted by Alan on June 30, 2001, at 1:00:55
> The partial problem is that the shorter acting Ativan is needed at about 5 MGS on only 3 - 4 days per week for performance anxiety (eves.)while the other days it would be too much.
>
> To keep from being overmedicated on the other days, only 3 MGS are needed. This is where the Nurontin comes in to mediate.Huh. So it doesn't work to just take the Ativan as needed -- 5 mg on the days you need that much, 3 mg on the other days? I can see how that could cause some ups and downs -- Ativan is pretty short-acting.
The Neurontin idea might be worth a try. It's kind of short-acting too. I've heard of some people taking the entire dose at bedtime, but I don't know how well that would work for your purposes. My other thought would be to use a small dose of a long-acting benzo (Klonopin, Tranxene) -- not enough to cause sedation, ataxia, or other unwanted side effects -- in the "background," and take the Ativan on top of that as needed. That might smooth things out.
> It's kind of a special social anxiety subcatagory that I have not been able to treat any other way.
Can you tell me more about that? Have you tried antidepressants? That might seem like overkill, but some of them (phenelzine especially) can be extremely effective for social anxiety, especially if you take benzos along with them.
> Alan (a fellow Chicagoan!)
Oops, didn't mean to mislead. I'm afraid I'm not from Chicago: I was recommending it as a place to find good doctors in the Midwest. Our own Dr. Bob, for example. < g >
best,
-elizabeth
Posted by Alan on June 30, 2001, at 19:21:07
In reply to your problem » Alan, posted by Elizabeth on June 30, 2001, at 17:47:37
> > The partial problem is that the shorter acting Ativan is needed at about 5 MGS on only 3 - 4 days per week for performance anxiety (eves.)while the other days it would be too much.
> >
> > To keep from being overmedicated on the other days, only 3 MGS are needed. This is where the Nurontin comes in to mediate.
>
> Huh. So it doesn't work to just take the Ativan as needed -- 5 mg on the days you need that much, 3 mg on the other days? I can see how that could cause some ups and downs -- Ativan is pretty short-acting.
>
> The Neurontin idea might be worth a try. It's kind of short-acting too. I've heard of some people taking the entire dose at bedtime, but I don't know how well that would work for your purposes. My other thought would be to use a small dose of a long-acting benzo (Klonopin, Tranxene) -- not enough to cause sedation, ataxia, or other unwanted side effects -- in the "background," and take the Ativan on top of that as needed. That might smooth things out.
>
> > It's kind of a special social anxiety subcatagory that I have not been able to treat any other way.
>
> Can you tell me more about that? Have you tried antidepressants? That might seem like overkill, but some of them (phenelzine especially) can be extremely effective for social anxiety, especially if you take benzos along with them.
>
> > Alan (a fellow Chicagoan!)
>
> Oops, didn't mean to mislead. I'm afraid I'm not from Chicago: I was recommending it as a place to find good doctors in the Midwest. Our own Dr. Bob, for example. < g >
>
> best,
> -elizabeth
=============================================
I like your idea of Kl. or Tr. in the background.One other problem with this though is that sleep architecture is already disturbed by relatively higher dosages of a benzo (which Neurontin counteracts to some degree) and therefore fatigued during the day from waking early and not enough deep sleep.
Neurontin has already been tried and works to a fair degree as long as taken 3x's a day but doses above 300 per dose causes psychomotor disturbance which is not cool for professional reasons.
Been through all the AD's and too stimulating for the type of anx. been treated. Remeron, Luvox considered but not tried yet. Every one of them have sexual side effects (including with the neurontin above 900 a day) unsuccessfully treated with all sorts of things.
Might have to consider MAOI's at some point but very hesitant because of similar side effects to previous tries with TCA's that can't be tolerated (dry mouth, const, dizzyness).Considered a low dose neuroleptic (Zyprexa) but afraid of TD. It really is for depression anyway isn't it?
Infrequent depression, just when spikes of anxiety drive it....
Any thoughts???? Thanks.
best,
Alan
Posted by Lorraine on June 30, 2001, at 20:34:42
In reply to Re: Addictive meds » Lorraine, posted by Alan on June 30, 2001, at 15:05:49
> > *********************************************
> > What about beta blockers, Alan? I think that performers use these a lot for performance anxiety.
> *******************************************
> Yes, I do use them but they only take care of some of the physiological symptoms and not the psychological ones. Thanks for the good suggestion though!
>************************************************
Alan, my anxiety is only physical--would beta blockers be good for me? Which ones have you tried?
> Best,
>
> Alan
Posted by Alan on June 30, 2001, at 22:29:10
In reply to Re: Addictive meds » Alan, posted by Lorraine on June 30, 2001, at 20:34:42
> > > *********************************************
> > > What about beta blockers, Alan? I think that performers use these a lot for performance anxiety.
> > *******************************************
> > Yes, I do use them but they only take care of some of the physiological symptoms and not the psychological ones. Thanks for the good suggestion though!
> >
>
> ************************************************
> Alan, my anxiety is only physical--would beta blockers be good for me? Which ones have you tried?
*********************************Inderal is all that I've used and in very small doseage - 10 - 20 MG.
Best,
Alan
Posted by paxvox on July 24, 2001, at 13:53:59
In reply to Re: mood disorders/klonopin,depakote,neurontin etc.... » dove, posted by Cece on March 9, 2001, at 13:15:54
Hmmmmmm....sounds as if my psydoc has been playing with you guys' psydocs! OK, I have had depression for 10+ years, and responded well to Prozac for a while. Since starting with current doc, I have "run the gamut" of the neuromeds. Mainline antidepressent has been Wellbutrin SR 150 x2 plus some benzos, which have varied from clonopin to Tranzene. Doc is calling me "depressed with OCD" he considered AADD (adult)
for a bit, but currently I'm a 300.3 OCD (see your DSM IV). After a recent bout of REALLY low mood, which I really believe was situational, doc has change my Wellbutrin to 200 SR x 2, and is trying to add Depakote for sleep, as I have early wakings, and to get me off the Tranzene. I haven't liked what I've read about Depakote. He has tried me on Topamax, Neurontin and other anti-seizure meds to no effect. Seems he's a GABA man. What thinks ye?
Posted by GregC on July 28, 2001, at 20:04:53
In reply to Re: mood disorders/klonopin,depakote,neurontin etc...., posted by paxvox on July 24, 2001, at 13:53:59
> Hmmmmmm....sounds as if my psydoc has been playing with you guys' psydocs! OK, I have had depression for 10+ years, and responded well to Prozac for a while. Since starting with current doc, I have "run the gamut" of the neuromeds. Mainline antidepressent has been Wellbutrin SR 150 x2 plus some benzos, which have varied from clonopin to Tranzene. Doc is calling me "depressed with OCD" he considered AADD (adult)
> for a bit, but currently I'm a 300.3 OCD (see your DSM IV). After a recent bout of REALLY low mood, which I really believe was situational, doc has change my Wellbutrin to 200 SR x 2, and is trying to add Depakote for sleep, as I have early wakings, and to get me off the Tranzene. I haven't liked what I've read about Depakote. He has tried me on Topamax, Neurontin and other anti-seizure meds to no effect. Seems he's a GABA man. What thinks ye?Well, I had a very low mood due to a difficult romantic relationship. It was causing me anxiety and I got diagnosed with a mood disorder. I was put on Prozac and Neurontin in May. The neurontin really makes me spacy so I am stopping taking it (today). I already feel a bunch better. I think sometimes we have to work though feelings due to circumstances beyond our control.
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