![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Spaced on February 23, 2000, at 11:01:34
I have been on medication and therapy treatment plan for GAD for the past three years. I have since moved and cannot find a doctor to prescribe diazepam for me, which is what I have been taking. My main symptom is anger.
My question: Besides the benzodiazepines, has anyone had any luck treating anxiety with medication? I started taking Depakote today - but I am not happy with the info I have found on this drug.
Posted by Cam W. on February 24, 2000, at 12:47:11
In reply to Anticipatory Anxiety, posted by Spaced on February 23, 2000, at 11:01:34
> I have been on medication and therapy treatment plan for GAD for the past three years. I have since moved and cannot find a doctor to prescribe diazepam for me, which is what I have been taking. My main symptom is anger.
>
> My question: Besides the benzodiazepines, has anyone had any luck treating anxiety with medication? I started taking Depakote today - but I am not happy with the info I have found on this drug.Spaced - I have seen some people benefit from Effexor or Paxil for GAD. Both of these can initially increase anxiety, but after a couple weeks either of them seem to kick-in and control the symptoms of GAD. After the initial side-effects subside (2-4 weeks) as your body adjusts to the medication, the remaining side-effects are usually benign. Both of these drugs are non-addicting. Have you asked the doctors what they would recommend for GAD. I find asking what they suggest gets more results than asking for a specific med.
The Depakote can be a good drug for mood stabilization. Do not let the side-effects profile scare you, as not everyone gets all of the potential side-effects. Depakote is probably more effective for GAD than is Valium, especially for the anger component. Give the Depakote a trial of a month or so and see if it works. Good luck - Cam W.
Posted by Cindy W on February 24, 2000, at 21:02:15
In reply to Re: Anticipatory Anxiety, posted by Cam W. on February 24, 2000, at 12:47:11
> Spaced - I have seen some people benefit from Effexor or Paxil for GAD. Both of these can initially increase anxiety, but after a couple weeks either of them seem to kick-in and control the symptoms of GAD. After the initial side-effects subside (2-4 weeks) as your body adjusts to the medication, the remaining side-effects are usually benign. Both of these drugs are non-addicting. Have you asked the doctors what they would recommend for GAD. I find asking what they suggest gets more results than asking for a specific med.
Cam, the Effexor-XR seems to help with anxiety, but lately I feel more depressed, even at 300 mg/day, and it hasn't completely knocked out the OCD rituals. Have you heard of Effexor-XR being helpful for OCD (the results I've read were mixed)? Thanks!--CIndy W
Posted by Cam W. on February 25, 2000, at 6:49:10
In reply to For Cam--Re: Anticipatory Anxiety, depression, OCD, posted by Cindy W on February 24, 2000, at 21:02:15
>
>
> > Spaced - I have seen some people benefit from Effexor or Paxil for GAD. Both of these can initially increase anxiety, but after a couple weeks either of them seem to kick-in and control the symptoms of GAD. After the initial side-effects subside (2-4 weeks) as your body adjusts to the medication, the remaining side-effects are usually benign. Both of these drugs are non-addicting. Have you asked the doctors what they would recommend for GAD. I find asking what they suggest gets more results than asking for a specific med.
>
>
> Cam, the Effexor-XR seems to help with anxiety, but lately I feel more depressed, even at 300 mg/day, and it hasn't completely knocked out the OCD rituals. Have you heard of Effexor-XR being helpful for OCD (the results I've read were mixed)? Thanks!--CIndy WCindy - While theoretically Effexor should work for OCD (OCD thought to involve serotonin pathways) I haven't seen it used with much success. How long have you been taking Effexor and how long have you been more depressed? Feeling down sometimes is normal, even while taking antidepressants. You could have the Effexor dose raised again for both the depression and for the OCD. OCD seems to respond better to higher doses of SSRIs (eg 60mg of Prozac or Paxil) and take longer to work, than for depression. It can take an SSRI 26 weeks to show improvement in OCD, so the wait can be frustrating. Also, if you have the Effexor dose raised it still may work better. Unlike SSRIs Effexor's dose-response curve is linear and doesn't plateau like the SSRIs. This means that increasing the dose of Effexor may show increased antidepressant effect, whereas with an SSRI (after a certain point) raising the dose does not increase efficacy. When you increase the Effexor dose (especially around the 300mg/day dose) it is like adding Desipramine to Paxil (adding an NSRI to an SSRI) as the norepinephrine reuptake blockade of Effexor begins to show. Maybe give the Effexor another week and see if this increased depression isn't just "the blues" and then ask your doctor about a dose increase or, if you feel warranted, a med change. Don't give up on an antidepressant too soon. Hope this helps - Cam W.
Posted by Cindy W on February 25, 2000, at 9:36:57
In reply to Re: Cindy Anticipatory Anxiety, depression, OCD, posted by Cam W. on February 25, 2000, at 6:49:10
> > Cam, the Effexor-XR seems to help with anxiety, but lately I feel more depressed, even at 300 mg/day, and it hasn't completely knocked out the OCD rituals. Have you heard of Effexor-XR being helpful for OCD (the results I've read were mixed)? Thanks!--CIndy W
>
> Cindy - While theoretically Effexor should work for OCD (OCD thought to involve serotonin pathways) I haven't seen it used with much success. How long have you been taking Effexor and how long have you been more depressed? Feeling down sometimes is normal, even while taking antidepressants. You could have the Effexor dose raised again for both the depression and for the OCD. OCD seems to respond better to higher doses of SSRIs (eg 60mg of Prozac or Paxil) and take longer to work, than for depression. It can take an SSRI 26 weeks to show improvement in OCD, so the wait can be frustrating. Also, if you have the Effexor dose raised it still may work better. Unlike SSRIs Effexor's dose-response curve is linear and doesn't plateau like the SSRIs. This means that increasing the dose of Effexor may show increased antidepressant effect, whereas with an SSRI (after a certain point) raising the dose does not increase efficacy. When you increase the Effexor dose (especially around the 300mg/day dose) it is like adding Desipramine to Paxil (adding an NSRI to an SSRI) as the norepinephrine reuptake blockade of Effexor begins to show. Maybe give the Effexor another week and see if this increased depression isn't just "the blues" and then ask your doctor about a dose increase or, if you feel warranted, a med change. Don't give up on an antidepressant too soon. Hope this helps - Cam W.Cam, thanks for the suggestions! I've been taking Effexor-XR for about 8 weeks now (now on 300 mg/day). Will see my pdoc next Thurs. Am. Don't know whether to ask for l) more Effexor-XR, say, 375 or 400 mg/day, 2) augmentation (e.g., Anafranil, gabapentin, risperdal), or 3) switch to Celexa, Paxil, or Anafranil. I think the Effexor-XR is helping but will see how it goes next week. --Cindy W
Posted by Cam W. on February 25, 2000, at 18:25:35
In reply to Re: Cindy Anticipatory Anxiety, depression, OCD, posted by Cindy W on February 25, 2000, at 9:36:57
>
>
> > > Cam, the Effexor-XR seems to help with anxiety, but lately I feel more depressed, even at 300 mg/day, and it hasn't completely knocked out the OCD rituals. Have you heard of Effexor-XR being helpful for OCD (the results I've read were mixed)? Thanks!--CIndy W
> >
> > Cindy - While theoretically Effexor should work for OCD (OCD thought to involve serotonin pathways) I haven't seen it used with much success. How long have you been taking Effexor and how long have you been more depressed? Feeling down sometimes is normal, even while taking antidepressants. You could have the Effexor dose raised again for both the depression and for the OCD. OCD seems to respond better to higher doses of SSRIs (eg 60mg of Prozac or Paxil) and take longer to work, than for depression. It can take an SSRI 26 weeks to show improvement in OCD, so the wait can be frustrating. Also, if you have the Effexor dose raised it still may work better. Unlike SSRIs Effexor's dose-response curve is linear and doesn't plateau like the SSRIs. This means that increasing the dose of Effexor may show increased antidepressant effect, whereas with an SSRI (after a certain point) raising the dose does not increase efficacy. When you increase the Effexor dose (especially around the 300mg/day dose) it is like adding Desipramine to Paxil (adding an NSRI to an SSRI) as the norepinephrine reuptake blockade of Effexor begins to show. Maybe give the Effexor another week and see if this increased depression isn't just "the blues" and then ask your doctor about a dose increase or, if you feel warranted, a med change. Don't give up on an antidepressant too soon. Hope this helps - Cam W.
>
> Cam, thanks for the suggestions! I've been taking Effexor-XR for about 8 weeks now (now on 300 mg/day). Will see my pdoc next Thurs. Am. Don't know whether to ask for l) more Effexor-XR, say, 375 or 400 mg/day, 2) augmentation (e.g., Anafranil, gabapentin, risperdal), or 3) switch to Celexa, Paxil, or Anafranil. I think the Effexor-XR is helping but will see how it goes next week. --Cindy WCindy - I like your idea of augmentation. I'll bet a little Anafranil or even Serzone might bump serotonin enough, or Lamictal (careful of rash) for mood stabilization (has antidepressant properties). Good luck - Cam W.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.