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Dr. Bob is Robert Hsiung, MD,
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Posted by highanxiety on December 28, 2002, at 14:19:44
In reply to Re: What drug worked best for your depression/anxi, posted by Dysfunk on December 28, 2002, at 12:48:18
im not sure if this is a bit off the beaten path topic wise...but the most wonderful relief I ever got from anxiety was after surgery, I got an IV of Zofran...was that great. After I recovered I found some an abstract I believe on Medscape that had to do with Zofran being effective for OCD. Of course for me there is a definite link (tic disorder OCD panic disorder)...I wonder if this drug will ever be approved for ocd or anxiety disorders..from what I remember smaller doses were used in the studay and were very effective, smaller than given for PONV and chemo.
Posted by worrier on December 28, 2002, at 20:08:18
In reply to Re: What drug worked best for your depression/anxi, posted by highanxiety on December 28, 2002, at 14:19:44
>The only meds that have helped me at all are benzos. Every antidepressant I tried just made things much worse (Wellbutrin,Prozac,Paxil). I don't have a big problem with depression...mainly the anxiety, and that is almost purely physical, I don't worry about "things" I worry about feeling anxious. This never happened until I took Paxil. It seemed to completely rewire my brain in a most unacceptable way. Before the paxil my "only" problem was panic attacks. Curious to know if anyone else has this primarily physical anxiety? Who's to say what drug is best seems everyone I know takes paxil or effexor with great success. Sorry to have babbled on so long ...this can be a long frustrating journey. Everyone hang in there.
Posted by ZeeZee on December 28, 2002, at 20:45:52
In reply to Re: What drug worked best for your depression/anxi, posted by worrier on December 28, 2002, at 20:08:18
I don't know if I'd call it "physical anxiety" but my anxiety and fears are about anxiety and fear, not "things" as you say. But that's the nature of panic disorder and agoraphobia - it's the fear of the fear.
In the past, Nardil and Parnate took all of this away for me and rather quickly. I highly recommend MAOI's for panic disorder if you can tolerate the effects and the diet.
Posted by HannahBeGood on December 29, 2002, at 1:35:04
In reply to What drug worked best for your depression/anxiety?, posted by Dysfunk on December 26, 2002, at 14:16:10
> I have been on so many of the older anti-depressants and then Prozac. Prozac was a miracle, I never felt better, then one day just stopped working and threw me into an awful depression. Since then I have tried a couple new drugs and ended up back on low doses of Prozac.Nothing seems to give me the same feeling I once had on Prozac. I recently combined Prozac and Effexor, and I am still trying to decifer if it works. It takes so long to go up on a drug and find the correct dosages.Very frustrating process!!
>
> I am just curious, in your experience with general ongoing depression and some anxiety, what has been the best drug treatment?Dysfunk~
Oh lord, it's the waiting 4-6 weeks and titration and eating like a pig and then feeling like you've been doibg absolutely n/t different exceopt spending money and swallowing pills til ya gag and s/time's nothin' seems to work at all, just nothin...
I've had depressive episodes since puberty, which I tended to by either actually getting physically sick (mono-AT 14) I was quarantined in my upstairs room for 6 weeks-I loved it, just books, art, sleep and dreams-FOR DAYS AND DAYS. Couldn't climb stairs with a swollen spleen & in the 70's it was believed mononucleosis was highly contagious for much longer than they do now.
Even now, only sleep and solitude for sev'l days (plus meds) can stabilize me for at least a couple of weeks.Wellbutrin helped me keep my head barely above water off & on for a yr. and a half. I have atypical depression and ADD (have only been dx'd w/that for 'bout a yr.). Remeron gave me good sleep, no a.m. grogginess and was a terrific, fast (one week) anxiolytic. Didn,t help depression, though.
Effexor at 300 mgs. 'helped' carry me thru unmanageable grief when my parents died. But did not help w/dep, mood, excess sleeping, ADD, or general inertia.I *must* have a dopamine safety net and booster to quell any significant part of my depression, plus a benzo, or I wd. startle every time the wind blew.
After a yr, my p-doc and I are still fine-tuning, but he is on the right track, knows I see a therapist and g.p. as well.
It's not perfect, but I am up and moving most days, can enjoy the world again and am not in the dark pit I was in for 3-4 mos. of summer'01.My med schedule:
15-60mgs. Dex spansules allowed per day
Us'ly take 451-4 mgs. Klonopin (I use clonazepam) allowed daily
take2-4 daily, but lately it's usually 3-415 mgs. Lexapro per day (can't tell any dif. after
8 weeks.)IR 40 mg. propanolol up to 3 a day (migraine prevention)
350 mgs. Soma (carisoprodal-a truly effective muscle relaxant), up to 3 x's a day-depends on whether I am in a pain 'flare' or not-often skip them, but when in pain, they are a ncessity.
darvocet , forgot the mgs, 350/100 or vice-versa, up to 2 daily (has some tylenol in it)
-the soma, propanolol and darv. are all for pain relief or prevention, so I don't take them every day, the propanolol, at least 40 mgs a day as it does quiet my physical anxiety symptoms best, theKingKong is clutching my heart' feeling which can totally immobilize me. The Klonopin is hard to explain, since it gives me more of a mental /intellectual smoothness or at least leveling, so my irrational thoughts have a harder time taking over my brain and leading me to say or think things that are just plain painful and unproductive. It has good mood stabilizing properties. So, if u used the prop and the klono together carefully, w/ur doc's guidance, I believe they can combine effectively.
I really believe the dexedrine/klonopin/prop'l combo has been my only "med" that has truly relieved me of about 55% of my symptoms. The small dose of Darvocet enhances this combination. But, I cannot take pain meds constantly due to tolerance and the dreaded "slow and or no" movement effects (constipation).
Of course, I am a chronic pain patient and I need those weak little darvocets to help me simply 'move' period. My p-doc allows me to keep 5mg dex IR on hand, so I don't crash and burn before my child does at bedtime. I sometimes will take 1 in the morning w/a (slow-release) spansuleor 2, as I am very difficult to awaken before the sun rises.I aspire to greater heights, but the past 5 yrs. have been very turbulent, and I believe I am still recuperating emotionally from unavoidable life events.
I still have tremendous bouts of fatigue, I isolate and I worry. But, I do have hope for the future.I think, w/patience, I may have a decent one. Hope u do, Too!
Hannah
Posted by Dysfunk on December 29, 2002, at 13:33:51
In reply to Re: What drug worked best for your depression/anxiety? » Dysfunk, posted by HannahBeGood on December 29, 2002, at 1:35:04
Hannah:
Thank you for your detailed response. I can imagine there must have been a lot of trial and error to reach a cocktail of 3 main meds that work for you. It is frustrating waiting it out to see if a med. works. You seem to have other complications, like pain, so I am happy you have found something. In time, I will too. All the best, Dysfunk! (PS- I had mono in the 70's too and slept for 2 months. It effected my liver and I was on a very restrictive diet)
Posted by justyourlaugh on December 29, 2002, at 16:24:42
In reply to Re: What drug worked best for your depression/anxi, posted by Dysfunk on December 29, 2002, at 13:33:51
you added you had mono as a teen.
i was checked many times for that-(neg)does that illness bring along a nero aspect?-
-cantremember where i am going here?-
i feel that depressed teens are shuffled under the rug.
i was told i was a drunk at 16.
but trying to cut off my own arm was ok....
i was drinking......
Posted by Dysfunk on December 30, 2002, at 19:53:13
In reply to Re: What drug worked-funk, posted by justyourlaugh on December 29, 2002, at 16:24:42
I was commenting to someone who said he or she had mono in the 70's. It is unrelated to the depression.
Posted by worrier on December 30, 2002, at 22:53:36
In reply to Re: What drug worked best for your depression/anxiety? » Dysfunk, posted by HannahBeGood on December 29, 2002, at 1:35:04
>just a question about the propanalol...because your comment about the King Kong clutching my heart thing really hit home with me. That describes the feeling exactly. I brought up the beta-blocker idea to my GP who vetoed it immediately...but she vetoes anything except antidepressants which I absolutely cannot take,but haven't talked to my psychiatrist about it yet. Do you notice any side effects from it? I find that my anxiety/panic manifests itself in primarily physical ways...not so much thoughts,etc. so this sounds like it might help.
Posted by temoigneur on December 31, 2002, at 1:26:19
In reply to Re: What drug worked best for your depression/anxi, posted by Dysfunk on December 28, 2002, at 12:46:07
> Ben: thanks for the info. I was on a pretty high dose of Prozac when it stopped working. Later, when I came back to it my dosage was medium. Still, I just can't seem to get the same effect I had.
Hi Dysfunk, gosh, I'm really hoping the prozac works out, do you mind if I ask how high a dose you were on when you said it stopped working initially, the doctor tried explaining to me that in quick metabolizers, he theorizes that perhaps raising the dosage to a level where your body can no longer "adjust" to it and cancel out the effects could be the answer.
He said to raise the dosage until the blood level of the metabolite (I think - you're doctor should know what they look for), was about 1000nano-grams/ml
Posted by Noa on January 1, 2003, at 13:38:24
In reply to Re: What drug worked best for your depression/anxi, posted by Dysfunk on December 29, 2002, at 13:33:51
Best combo so far, but far from perfect:
effexor xr 262.5 mg
adderall xr 30 mg
serzone 500 mg
lorazepam .25 mg
synthroid 50 mcg
cytomel 25 mcg
folic acid 400-800 mcg
chromium picolinate 400 mcg
Posted by Sswift on January 2, 2003, at 7:40:06
In reply to Re: What drug worked best for your depression/anxi, posted by worrier on December 28, 2002, at 20:08:18
Can anyone tell me of any meds for anxiety/depression that does not cause weight gain? I have been on Paxil for I think a year now and have gained about 30 pounds from it. Any suggestions??
Posted by fairnymph on January 2, 2003, at 14:08:21
In reply to What drug worked best for your depression/anxiety?, posted by Dysfunk on December 26, 2002, at 14:16:10
I suffer from obsessive compulsive disorder (a type of anxiety disorder) and depression. Prozac worked the best for me (I haven't tried any other SSRIs), even though I was only on it for 2 months, the antidepressant effects lingered for a few months after! I went off it because I couldn't stand the sexual side effects.
Effexor worked fairly well, but it stopped working (even after I maxed out the dose) after a couple months. And even when it worked best it didn't help as much as Prozac. BUT I loved the fact that on Effexor I still had a libido, even if I still couldn't orgasm. Also, Effexor gave me a lot of energy throughout the day and I lost some weight on it (appetite supressing).
Reboxetine was great for my depression, and had ZERO side effects at 8 mg a day (other than increased libido). It gave me a lot of energy and seemed to increase my intellectual abilities. It didn't help with my anxiety or ocd symptoms though . :( BUt, I recommend it highly to anyway who is suffering from straight depression.
Remeron, tianeptine, and wellbutrin did NOTHING for me at all.
Good luck, hope you find a drug that works for you again.
~fairnymph
fairnymph@ziplip.com
> I have been on so many of the older anti-depressants and then Prozac. Prozac was a miracle, I never felt better, then one day just stopped working and threw me into an awful depression. Since then I have tried a couple new drugs and ended up back on low doses of Prozac.Nothing seems to give me the same feeling I once had on Prozac. I recently combined Prozac and Effexor, and I am still trying to decifer if it works. It takes so long to go up on a drug and find the correct dosages.Very frustrating process!!
>
> I am just curious, in your experience with general ongoing depression and some anxiety, what has been the best drug treatment?
Posted by HannahBeGood on January 2, 2003, at 22:03:39
In reply to Re: What drug worked best for your depression/anxiety? » HannahBeGood, posted by worrier on December 30, 2002, at 22:53:36
Hi worrier-
Sorry took so long to reply. I was first prescribed Inderal (generic = propanolol) after I had my 1st child at 40. I had taken phentermine off and on to help me lose pregnancy weight. When I quit after about a yr., I had terrible bouts of anxiety, and this was *after* I quit taking it. So, after some consideration of my B.P. checks while I was dieting, they slowly rose over time, and worried about the phen-fen situation (i only filled the fenfluramine part of my RX 2 or 3 times, then stopped, due to the sensationalistic news reports that were flying around at the time). The combo WAS an incredible anorexic and I had to force food when I took both at once. Losing weight was a snap.But, as I said a few mos. afterwards I went to my g.p., and we arranged a stress test. I did well, close to top 20% in endurance and I was slim no cholesterol problems. The cardio doc said , Well, you're probly gonna be on meds for life, cuz w/u I think it's simply genetics. I never mentioned the phentermine to either doc. Took 120 mgs SR daily of propanollol or Inderal, forget if the generic came in SR. Within one week my B.P. went from a high of around 160/105 back to my usual 110/60. I titrated off of it later, as I was having no symptoms and wanted to see how my pressure was, and it remained normal to lowish.
I was then prescribed it for chronic headaches, but have only used it 20-120 mgs. a day, as the situation merits. The past yr. has been a hard one and I average about 80 mgs. daily.It doubles as a pain preventative and as a good med for 'physical' anxiety. Performers are often prescribed it so they can control their thumping hearts and sweaty palms during stressful concerts, plays, etc.
Taking a beta-blocker can lower your blood pressure 'too' much, if u're not careful. It also can cause fatigue and depression in some patients. You're doc may have been considering these possibilities, but it wd. be nice if he/she wd. 'share' and explain, if this is the case, no? How is ur BP usually? High, low, just right?
Ask more questions about this med possibility, as I have used it off and on for 5 yrs, and only with good results. One is cautioned not to discontinue use abruptly, but, rather to titrate down slowly, with a dr's guidance. (I think this is a warning that will become ubiquitous with all drugs in the near future. With many it is certainly warranted, but I think we are reaching a kind of mass hysterical paranoia about stopping any drug these days & then suffering unbearable side-effects). I have simply 'quit' many in the past (with no problems at all, before anybody knew any better, supposedly) but, that was before some of the real ass-kickers came along (like Effexor-which I did discontinue after 9 months, but, verrrry slowly and carefully). That was one I did feel withdrawal effects from. But titrating properly and starting lexapro during the FXR drop minimalized the effects to almost nothing.
Let me know how things go for u. All the best~Hannah
Posted by Cisco on January 4, 2003, at 13:38:14
In reply to Re: What drug worked best for your depression/anxiety? » worrier, posted by HannahBeGood on January 2, 2003, at 22:03:39
I've had amazing anti-depressive results with certain non-selective serotonin sub-receptor (5-HT1A, 5-HT2A, 5-HT2C, 5-HT4, etc) agonist's, which are derived from from the indolealkylamine class of medications.
Cisco
Posted by temoigneur on January 4, 2003, at 16:57:38
In reply to Re: What drug worked best for your depression/anxiety?, posted by Cisco on January 4, 2003, at 13:38:14
> I've had amazing anti-depressive results with certain non-selective serotonin sub-receptor (5-HT1A, 5-HT2A, 5-HT2C, 5-HT4, etc) agonist's, which are derived from from the indolealkylamine class of medications.
>
> CiscoMy Gosh, I've been searching frantically, emailing doctors in europe and everwhere to get a hold of a 5-HT2A agonist, how did you get access to these drugs
Thanks a million
Posted by worrier on January 11, 2003, at 19:55:50
In reply to Re: What drug worked best for your depression/anxiety? » worrier, posted by HannahBeGood on January 2, 2003, at 22:03:39
Thanks for the info. perhaps my GP was concerned about the bp thing, but she never really seemed to listen to anything I said anyway. Before my really bad experience with paxil, my bp had been perfectly normal or even a little on the low side. While on paxil ( which caused my panic/anxiety to increase to intolerable levels) it went up to 130-135/80-85. Weird thing is that it has stayed there after 8 months of being off the paxil. I know that that is considered a normal bp, but it's not normal for me...a fact my dr. completely ignored. My sister takes a beta-blocker for migraine prevention and has had problems when trying to come off of it...she gets jittery, heart pounds,etc. So I know they should be used with caution. Need to see my pdoc sometime soon and will discuss this with him. Will let you know what happens. Worrier.
Posted by worrier on January 11, 2003, at 20:17:21
In reply to Re: What drug worked best for your depression/anxiety?, posted by Cisco on January 4, 2003, at 13:38:14
> I've had amazing anti-depressive results with certain non-selective serotonin sub-receptor (5-HT1A, 5-HT2A, 5-HT2C, 5-HT4, etc) agonist's, which are derived from from the indolealkylamine class of medications.
>
> Cisco> What about anti-anxiety effects of these meds? I'm not even familiar with this class of drugs...where can I find some info? Thanks, worrier.
Posted by Cisco on January 12, 2003, at 3:27:39
In reply to Re: What drug worked best for your depression/anxiety?, posted by temoigneur on January 4, 2003, at 16:57:38
This is a very interesting class of endogenous SSRA's (Serotonin Sub-Receptor Agonist's). Hey, I just invented a new class of AD's!
However, it would be preferable to discuss in detail over cyber coffee. If you are interested, e-mail me at cisco255@hotmail.com
Cisco
Posted by patricia22w on August 24, 2003, at 15:48:51
In reply to Re: What drug worked best for your depression/anxi, posted by highanxiety on December 28, 2002, at 14:19:44
> im not sure if this is a bit off the beaten path topic wise...but the most wonderful relief I ever got from anxiety was after surgery, I got an IV of Zofran...was that great. After I recovered I found some an abstract I believe on Medscape that had to do with Zofran being effective for OCD. Of course for me there is a definite link (tic disorder OCD panic disorder)...I wonder if this drug will ever be approved for ocd or anxiety disorders..from what I remember smaller doses were used in the studay and were very effective, smaller than given for PONV and chemo.
xxxx
I had the same experience. I was given remeron but it wasn't helping so they switched to zofran and I felt better than I ever remember in my life. I had no anxiety in talking to people where as normally am practically agoraphobic. I've asked my primary care physician if he could prescribe it for anxiety depression but he said it is only for chemo or post operative nausea. He's prescribed other antidepressants which I've tried but don't like the side effects and have heard so many negative experiences people have had taking them, that I end up going off them and not really giving them a chance. I was just wondering is there any way I could get a prescription for zofran that anyone knows of. My insurance covers it (I checked with the pharmacy)I've seen it for sale on the internet without a prescription, but can not afford to buy it right now. Is there any way that glaxo-wellcome could do a study on zofran for anxiety depression and I could volunteer? Thanks for the help.
Patricia
Posted by El on August 24, 2003, at 22:01:11
In reply to Re: What drug worked best for your depression/anxi » highanxiety, posted by patricia22w on August 24, 2003, at 15:48:51
well i can tell you this paxil had me more scared than i have ever felt in the first week and it lasted 2 full days, lexapro was taking me down the same path. i couldnt take either for more than a week. i am in the market now too and looking for suggestions! i hear the benzos are the best, but im no doctor and i havent talked to mine about them yet! and i am a physically anxiety stricken person bordering agoraphobia as well and cant deal with those side effects.
Posted by btnd on August 25, 2003, at 14:36:36
In reply to Re: What drug worked best for your depression/anxi, posted by El on August 24, 2003, at 22:01:11
Definitely Klonopin. My depression was (is?) due to problems with anxiety. Klonopin not only helps with the anxiety (both social and general), it also makes me antidepressed and pro-social.
I also used Xanax and it has even more pronounced antidepressive effect, unfortunately it has short action. I hope this problem will be fixed when I try the slow release version Xanax SR.Take care,
Brad
Posted by El on August 25, 2003, at 16:23:48
In reply to Re: What drug worked best for your depression/anxi, posted by btnd on August 25, 2003, at 14:36:36
Did klonopin (or Xanax) give you any side effects? i hate feeling spacey or lightheaded, this causes me to have anxiety attacks. so i pretty much cant take anything that alters my perception or makes me feel any different than i *normally* do. that probably rules out nearly ALL possible drugs that i can take, but i am searching and hopeful. also did you take them just when you needed them or all the time? my doc has suggested a prescript that i only take when i need it, not all the time, to alleviate those se's that freak me out.
El
Posted by Viridis on August 26, 2003, at 5:02:53
In reply to Re: What drug worked best for your depression/anxi, posted by El on August 25, 2003, at 16:23:48
Klonopin and Xanax have been very effective for me, and the good news with these (and other benzodiazepines) is that tolerance usually develops quite rapidly to the side effects, but not the anti-anxiety effects. It took me about a week or two to get over some mild sleepiness/clumsiness/brain fog with daily Klonopin use, and since then I've had no side effects at all.
One strategy might be to take it before bed at first, when these things aren't such a problem. I did this initially, but found that the anti-anxiety effect wore off by about the middle of the next day, so now I take it in the AM. However, taking it at night at least in the beginning could help you avoid feeling spacey during the day.
Of course, if you only take the meds as-needed, you may find that the side effects do occur. Why not try a very small dose, see how you feel, and work up from there if it's appropriate?
Klonopin is a great drug for me, both for anxiety and the depression that results from anxiety. As another poster mentioned, Xanax seems to have a more pronounced antidepressant effect, and with the new extended-release form (which I haven't tried) could also be a good option.
Posted by Peter on August 26, 2003, at 5:41:03
In reply to Re: What drug worked best for your depression/anxiety?, posted by Aadika on December 27, 2002, at 21:01:46
> I've found that relatively high-dose clonazepam (2mg bid, + 1mg hs) in addition to Provigil (200mg qd) and propranolol (10mg bid) has worked wonders for me. (I have avoidant personality disorder [basically severe social phobia] as well as dysthymia) Best of luck to you!
>
> ~ Aadika
>>Hi:
You know, I've heard it said a lot that provigil is a really good, smooth-acting stimulant that does a great job at counteracting benzo-induced fatigue. I've been taking klonopin at differing doses for 5 or 6 years now - only in the last few weeks have I gone up as high as 3.5mg daily. My pdoc has me taking adderall to help provide 'pep,' and to help the probable adult ADHD I have. I guess provigil isn't effective for ADHD?
Adhd aside, what do you find effective about provigil in your current combo?
Also, does the provigil raise your resting heartrate? I found that other stims, like adderall or dex, raised my RHR to the point that my pdoc used to add beta-blockers, like propranolol. But I always found that beta-blockers to somehow counteract that energy-providing benefits of the stims - and I didn't like the idea of my heart going thru a kind of 'push-pull' experience - up from the stim, down from the beta-blocker. Why do you take prop. and in what way is it effective in combo w/your other meds?
thanks,
Peter
Posted by btnd on August 26, 2003, at 6:05:52
In reply to Re: What drug worked best for your depression/anxi, posted by El on August 25, 2003, at 16:23:48
> Did klonopin (or Xanax) give you any side effects? i hate feeling spacey or lightheaded, this causes me to have anxiety attacks. so i pretty much cant take anything that alters my perception or makes me feel any different than i *normally* do. that probably rules out nearly ALL possible drugs that i can take, but i am searching and hopeful. also did you take them just when you needed them or all the time? my doc has suggested a prescript that i only take when i need it, not all the time, to alleviate those se's that freak me out.
> ElI now have no side-effects whatsoever. During the 1st week I was little *slow* and had some problems with my short term memory (for example I was talking to few people and 2 hours later I didn't know what was the topic of the conversation :) but it all eventually went away.
Brad
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