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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by blayton on July 16, 2001, at 12:38:23
This is my first post on this board , so I will have to be slightly verbose in describing my problems . Please excuse the length.
I am 25 and suffer from an unusual variant of GAD( or so my present shrink tells me ) . Eight years ago , while preparing for an exam at high school , I was suddenly stricken by fears regarding what would happen if I were obsessed with fear thoughts during the course of giving the examination . That happened 8 years ago , but it still describes the crux of my problems : " continuously worrying about being worried in a critical situation "( I picked that phrase from an Internet site describing GAD and which beautifully summarises my problems ) . I have problems concentrating , as I am always monitoring my thoughts . You have to go through this to experience how disgusting and self-defeating it feels .
I was initially diagnosed with OCD although I have never had any compulsions anytime . I started Prozac in high doses ( 80 mg ) and found substantial relief from the frequency of the obsessive worries but somehow the core fears remained and would spring up whenever a high tension situation arose . But Prozac enabled me to get back to normal work and I pulled on . Then poop-out hit after 31/2 years . After unsucessfully trying many drugs , I finally found success with Zoloft. 100 mg and for about 11/2 years , I was as good as normal, or as normal as I remember normal to be . Then Zoloft pooped , and supplementation with Buspar pulled the cart for another year or so , Buspar dosage gradually increasing . Then the combo also stopped working three months back.
I changed doctors , and was diagnosed with GAD . I have been on Effexor for nearly five weeks now , being at 150 mg. for the last five days . I have noticed partial improvement , lets say 50-60 % but still have spells of high anxiety , all of which is anticipatory , and some of which involve conditions I am likely never to be involved in .
This fear of one's own thoughts and continuous monitoring of my own mind has left me very depleted mentally . Has anyone else suffered from any such symptom ? Is it indicative of GAD and if so, does Effexor work ? Also , how long does it take to work ?
Thank you for your attention . Any advice would be appreciated .
PS I have tried CBT twice , it made no difference to me .
Posted by Janelle on July 16, 2001, at 14:54:22
In reply to Is it GAD? Does Effexor work for GAD?, posted by blayton on July 16, 2001, at 12:38:23
Hi there,
You expressed yourself beautifully here, and I can relate to your symptoms, as they describe my anxiety better than I ever could! It is so hard to put these kinds of feelings into words.
Anyway, Effexor is the only so-called SSRI anti-depressant to be "officially" recognized as working on both GAD and depression.
I'm currently on it and cannot stand it - if anything, the stuff is making my anxiety WORSE, and I had to cut back from 150mg to 75mg. I've posted about this several other threads on this board and gotten very helpful answers.
My anxiety sounds very much like yours, plus I have other types of obsessive, racing thoughts that bother and prevent me from functioning properly.
I do not know if this symptom - fear of one's own thoughts and continuous monitoring of one's own is one of the "official" (DSM) criteria for GAD, but it sure sounds like it could be.
From what I've read here and keep hearing all over the place, it will take Effexor at least 4-6 weeks to kick in and "work." That amount of time with MINIMAL or NO results will let you know it is NOT really working. Waiting it out and being patient can be sooooooo difficult, at least for me.
My questions for you are:
1) What Internet site did you find that phrase to describe your anxiety?? It sounds like a good site, one I'd like to see.2) What is "CBT" - you said you tried that twice and it didn't work. The only thing I can think it might mean is Cognitive Behavioral Therapy??
Thanks and good luck. Stick it out with the Effexor a bit longer if you can since thus far you're getting partial results. Just my humble opinions.
-Janelle
Posted by DebbieLynn on July 16, 2001, at 21:39:09
In reply to BLAYTON: Comments and questions for you here: » blayton, posted by Janelle on July 16, 2001, at 14:54:22
> Hi there,
>
> You expressed yourself beautifully here, and I can relate to your symptoms, as they describe my anxiety better than I ever could! It is so hard to put these kinds of feelings into words.
>
> Anyway, Effexor is the only so-called SSRI anti-depressant to be "officially" recognized as working on both GAD and depression.
>
> I'm currently on it and cannot stand it - if anything, the stuff is making my anxiety WORSE, and I had to cut back from 150mg to 75mg. I've posted about this several other threads on this board and gotten very helpful answers.
>
> My anxiety sounds very much like yours, plus I have other types of obsessive, racing thoughts that bother and prevent me from functioning properly.
>
> I do not know if this symptom - fear of one's own thoughts and continuous monitoring of one's own is one of the "official" (DSM) criteria for GAD, but it sure sounds like it could be.
>
> From what I've read here and keep hearing all over the place, it will take Effexor at least 4-6 weeks to kick in and "work." That amount of time with MINIMAL or NO results will let you know it is NOT really working. Waiting it out and being patient can be sooooooo difficult, at least for me.
>
> My questions for you are:
> 1) What Internet site did you find that phrase to describe your anxiety?? It sounds like a good site, one I'd like to see.
>
> 2) What is "CBT" - you said you tried that twice and it didn't work. The only thing I can think it might mean is Cognitive Behavioral Therapy??
>
> Thanks and good luck. Stick it out with the Effexor a bit longer if you can since thus far you're getting partial results. Just my humble opinions.
> -JanelleJanelle:
Sorry to butt in, but I have been reading your posts. I too am on Effexor XR 225mg. I have been on it for a total of 6 months, but at this 225mg dose for about 3 months. I have GAD as well, just like it is being described here. I also have mild depression, which sometimes seems to run hand in hand with anxiety. At 75 mg, my anxiety was worse also, and at 150 mg, it was even worse I HATED IT! I was also extremely tired. BUT...when I was bumped up to 225mg, I did not have any side effects with the increase. I started feeling the effects about 4 weeks on this dose, and MAGICALLY I started feeling so much better. Effexor has been a life saver for me. I find it actually hard to worry obsessively like I used to do. I am the queen of worrying.(USED TO BE the queen, not anymore! :)) Now I am much more laid back.Again...sorry to ramble...but maybe you should consider an increase.... ;)
P.S. The only problem I HAD when I started this dose was not being able to go to sleep at night. When I finally did, I kept waking up. I am also on 50mg of Trazadone a night (as needed)
Good Luck
Debbie
Posted by blayton on July 17, 2001, at 1:56:24
In reply to BLAYTON: Comments and questions for you here: » blayton, posted by Janelle on July 16, 2001, at 14:54:22
There are a few web sites describing this type of syptom and attributing it to GAD . Two the URLs are :
www.beckinstitute.org/october2000/clinical.html
http://www.psychologyinfo.com/DrFranklin/generalized.htmlAs for CBT , it is Cognitive Behavioral Therapy which was a waste for me .
You said you could not tolerate Effexor . Have you tried Zoloft ? It gave me great relief but sadly it has pooped out .
Posted by Mr.Scott on July 17, 2001, at 12:51:00
In reply to To Janelle , posted by blayton on July 17, 2001, at 1:56:24
Blayton,
Both You and Janelle sound very much like me with the racing obsessive thoughts and fears. I also tend to get depressed. Because of this I have recently focused on Bipolar II, but really whatever you seem to have seems quite fitting for me as well. I have had relief with Klonopin, but am currently looking for a more mainstream anticonvulsant. Largely out of fear about benzodiazepines, and because I am thinking the anticonvulsant might also help stabilize the depression.
Mr.Scott
Posted by Wendy B. on July 18, 2001, at 2:54:37
In reply to Racing obsessive thoughts, posted by Mr.Scott on July 17, 2001, at 12:51:00
> Blayton,
>
> Both You and Janelle sound very much like me with the racing obsessive thoughts and fears. I also tend to get depressed. Because of this I have recently focused on Bipolar II, but really whatever you seem to have seems quite fitting for me as well. I have had relief with Klonopin, but am currently looking for a more mainstream anticonvulsant. Largely out of fear about benzodiazepines, and because I am thinking the anticonvulsant might also help stabilize the depression.
>
> Mr.Scott
I am diagnosed bipolar II, and am on Wellbutrin for depression, and neurontin for mild anxiety and mood stabilization. I've never been diagnosed with GAD, but some of your (Blayton's) descriptions fit me well - the worrying about the worrying especially. I did also at one point in the breakup of my marriage have lots of panic-attacks and mucho anxiety, for which I was prescribed Xanax (alprazolam), a benzodiazepine. I still take it from time to time, when I get agitated about things. Valium and Klonopin (clonazepam) are in this same family of drugs.I find it very strange that the doctors you've seen have never suggested a benzo for you. Many, many people take it every day for years, and never become addicted, one of the supposed problems with this class of drugs. But read discussions on this board (use the search function). You will find many people on xanax at the same dosage, for years. Others disagree about the xanax, but then you could try klonopin.
Just by doing a quick search of the most recent posts, you can check this thread on Klonopin:
http://www.dr-bob.org/babble/20010310/msgs/56193.html… or this one on xanax tolerance:
http://www.dr-bob.org/babble/20010122/msgs/52590.htmlI am no doctor, but you maybe need a second opinion to sort all of this out. Good luck...
Wendy
Posted by blayton on July 18, 2001, at 3:32:36
In reply to Re: Racing obsessive thoughts, posted by Wendy B. on July 18, 2001, at 2:54:37
Wendy,
I do take Xanax on a as-needed basis , particularly during the high-anxiety periods in my life . It works very well on such occasions . But I am careful not to build up tolerance as this is the only thing that works with certainty when required . I have never had to go beyond 2 mg though and I have never taken it for more than a month at a stretch .
I do not have any depression or bipolar symptoms , just continuous anxiety about almost everything and particularly when I am working or doing something important . Low self-esteem is another component of my cocktail.
Thanks for the information on the threads . It was very useful.
Posted by Alan on July 19, 2001, at 1:29:18
In reply to Re: Racing obsessive thoughts, posted by blayton on July 18, 2001, at 3:32:36
> Wendy,
> I do take Xanax on a as-needed basis , particularly during the high-anxiety periods in my life . It works very well on such occasions . But I am careful not to build up tolerance as this is the only thing that works with certainty when required . I have never had to go beyond 2 mg though and I have never taken it for more than a month at a stretch .
> I do not have any depression or bipolar symptoms , just continuous anxiety about almost everything and particularly when I am working or doing something important . Low self-esteem is another component of my cocktail.
> Thanks for the information on the threads . It was very useful.
*******************************************
Do I understand it right that the only complete relief you get is from xanax? Or just when the panic is overwhelming you? If it's the former I'd be asking the same questions about why you aren't on benzodiazapines.Your concern (or doctor's I don't know which) is really unfounded about addiction. If it works for you you are not addicted but medically or pharmalogically dependent - big difference. Tolerance is not an issue for most people and this much maligned drug (mainly from people that don't understand it) is the first line of defense against anxiety disorders. I know because I've been on it for many years and sure I need a medium-high dose but so what? I have my life back. You're not an "addict" by any stretch.
When and if you decide to stop, you just have to taper them, that's all - just like every other med (as it's turning out) whether it fits the strict definition of "addictive" or not.
There are many types of benzos to try and they will all have a differing effect on you - allot of variety to fit what you may need.
If your doctor is worried about "addiction" and you tell them that you simply feel better on the benzos (5 MG's of it if that's what works), they're not listening to you. I'd consider getting a second opinion from someone that understands and specialises in treating chronic anxiety disorders.
I had this same problem until I found the right pdoc. It took 5 years and 3 of them but I finally found one that asked one simple question when on a new med - "well, do feel better?". That's all I needed to know.
Good Luck.
Alan
Posted by girlie on July 25, 2001, at 8:34:11
In reply to Is it GAD? Does Effexor work for GAD?, posted by blayton on July 16, 2001, at 12:38:23
I have very similar symptoms of GAD - obsessive, dibilitating, panic stricken thoughts that I can't get rid of.
I have been on Effexor XR for 5-1/2 years and it's been wonderful for me! The highest dose I was on was 300mg/day, which I just reduced to 225mg in the process of getting off Effexor because I want to get pregnant. It took a couple of years for me to get to 300mg (doctor just increased as necessary). It really helped with my anxiety - more than I thought anything could. I was lucky and haven't had any HORRIBLE side effects, although there are some.
I now start the long, ugly road of withdrawal, but I wish you luck and calm on Effexor XR!
girlie
Posted by itisme on July 25, 2001, at 9:27:00
In reply to Re: Is it GAD? Does Effexor work for GAD? » blayton, posted by girlie on July 25, 2001, at 8:34:11
Girlie....
I appreciate you honest observations of your experiences with Effexor XR. I'm at work and should be working, but I find myself reading posts and thinking about my current 1.5 weeks of effexor. It is interesting, hope bringing, and scarey all at the same time, but I guess it has been with all meds. I must admit I've heard more negative things about Effexor than about others I've been on (Paxil may be close).I do think that if you want to find positive results... it will be rarely found here. If I'm doing well I'm not going to spend time reading these messages.... I'm going to be living my life and having fun.
Wellbutrin was absolutely horrible for me, but peoples brain chemistries are different and it could work for others. I was on Effexor a long time ago for ADD and it didn't help so I tapered down and had zero side effects. In fact I ddin't even know I was on it ever. So I'm not going to worry myself with the negative things spoken about Effexor.
One of the most important things we who are suffering need is hope. Hope is what keeps me going. I know I will be okay at some point, I just need to keep pushing forward finding joy where I can.
Sorry my messages are always so fragmented.... I guess I just like to write my thoughts down... that and I still have ADD :)
Peace.
Posted by dmel75 on July 25, 2001, at 10:22:22
In reply to Is it GAD? Does Effexor work for GAD?, posted by blayton on July 16, 2001, at 12:38:23
Did you feel fuzzy headed? I have an appt with a therapist on Friday for the first time ever. I have constant worry, anxiety and sometimes panic over things I can't control and most likely would never happen. Lately it seems I'm being physically affected by it, fuzzy headed headaches, bloodshot eyes, etc. I'm getting plenty of sleep and otherwise feel ok. Whenever I begin to feel this way I start to panic that it's something else wrong with me. I'm wondering, if the therapist puts me on meds what meds will they be? Sorry if this is off topic!
>
> This is my first post on this board , so I will have to be slightly verbose in describing my problems . Please excuse the length.
>
> I am 25 and suffer from an unusual variant of GAD( or so my present shrink tells me ) . Eight years ago , while preparing for an exam at high school , I was suddenly stricken by fears regarding what would happen if I were obsessed with fear thoughts during the course of giving the examination . That happened 8 years ago , but it still describes the crux of my problems : " continuously worrying about being worried in a critical situation "( I picked that phrase from an Internet site describing GAD and which beautifully summarises my problems ) . I have problems concentrating , as I am always monitoring my thoughts . You have to go through this to experience how disgusting and self-defeating it feels .
>
> I was initially diagnosed with OCD although I have never had any compulsions anytime . I started Prozac in high doses ( 80 mg ) and found substantial relief from the frequency of the obsessive worries but somehow the core fears remained and would spring up whenever a high tension situation arose . But Prozac enabled me to get back to normal work and I pulled on . Then poop-out hit after 31/2 years . After unsucessfully trying many drugs , I finally found success with Zoloft. 100 mg and for about 11/2 years , I was as good as normal, or as normal as I remember normal to be . Then Zoloft pooped , and supplementation with Buspar pulled the cart for another year or so , Buspar dosage gradually increasing . Then the combo also stopped working three months back.
>
> I changed doctors , and was diagnosed with GAD . I have been on Effexor for nearly five weeks now , being at 150 mg. for the last five days . I have noticed partial improvement , lets say 50-60 % but still have spells of high anxiety , all of which is anticipatory , and some of which involve conditions I am likely never to be involved in .
>
> This fear of one's own thoughts and continuous monitoring of my own mind has left me very depleted mentally . Has anyone else suffered from any such symptom ? Is it indicative of GAD and if so, does Effexor work ? Also , how long does it take to work ?
>
> Thank you for your attention . Any advice would be appreciated .
>
> PS I have tried CBT twice , it made no difference to me .
Posted by blayton on July 26, 2001, at 8:36:07
In reply to Re: Is it GAD? Does Effexor work for GAD? » blayton, posted by girlie on July 25, 2001, at 8:34:11
Can you tell me how long after you started Effexor did you feel significant relief( say 80 % ) ? And at what dose ?
I do feel relief from Effexor , but the increment in efficacy is very slow . Now I have been two weeks on 150 mg after being on 75 mg for four weeks .
I do not worry about side-effects , though I am having plenty . If the drug works , I shall think about other medications to solve the side-effects . I want to give Effexor a fair trial , but the increase in benefits is ever so slow . Is it normal with Effexor that you feel better gradually until you reach a stage where you can call yourself to be in remission ? It is all very confusing .
Sorry to be a little wordy , but since you have been on Effexor for 5+ years and have had a positive effect , I thought you would be able to fill me in with some details .
Posted by girlie on July 26, 2001, at 9:37:43
In reply to Re: Does Effexor work for GAD? to girlie, posted by blayton on July 26, 2001, at 8:36:07
> Can you tell me how long after you started Effexor did you feel significant relief( say 80 % ) ? And at what dose ?
> I do feel relief from Effexor , but the increment in efficacy is very slow . Now I have been two weeks on 150 mg after being on 75 mg for four weeks .
> I do not worry about side-effects , though I am having plenty . If the drug works , I shall think about other medications to solve the side-effects . I want to give Effexor a fair trial , but the increase in benefits is ever so slow . Is it normal with Effexor that you feel better gradually until you reach a stage where you can call yourself to be in remission ? It is all very confusing .
> Sorry to be a little wordy , but since you have been on Effexor for 5+ years and have had a positive effect , I thought you would be able to fill me in with some details .
Glad to help, if I can. It's been so long since I first started....let's see, I think it was about 3 weeks before I noticed small things, and 3-4 months before I noticed the big things. I think I was at 150mg at the time.The thing is, I didn't wake up one day and say, WOW I feel better! I just DID (or DIDN'T do)things I would have before. I would realize, sometimes after the fact, that I hadn't thrown myself into an anxiety attack over something, that I just dealt with it when the time came. Not to say that I never worried, but it didn't control my life.
I remember my doctor telling me, when he prescribed the medicine, that if it was Monday and I had something going on on Thursday, I wouldn't worry about it every day until Thursday. I told him that he was crazier than I was if he thought that was going to happen to ME! But he was right!
It just came gradually and, like I said, I noticed some things after the fact. I did visit my parents (who live in another state) about a month after I went on Effexor. I think I was at 75mg at the time. I hadn't told them I was on the medication and, after the trip, my mom called to tell my that she and my dad were talking about how relaxed I was on the trip and what a great time they had with me. (I'd never been the kind of person to be described as "relaxed" before!) I told her about the medication then and she said, "stay on it, it works great!" LOL
Sorry so wordy, just want to help!
girlie
Posted by Willow on July 26, 2001, at 9:56:10
In reply to Re: Does Effexor work for GAD? to girlie » blayton, posted by girlie on July 26, 2001, at 9:37:43
>....let's see, I think it was about 3 weeks before I noticed small things, and 3-4 months before I noticed the big things. I think I was at 150mg at the time.
>
> The thing is, I didn't wake up one day and say, WOW I feel better! I just DID (or DIDN'T do)things I would have before. I would realize, sometimes after the fact, that I hadn't thrown myself into an anxiety attack over something, that I just dealt with it when the time came. Not to say that I never worried, but it didn't control my life.Blayton, Girlie's description is perfect. I've kept having improvement after eight months. I've been on since Sept or Oct. The side-effects go away slowly about 3-6 weeks, but return with each dose increase for awhile. I've had success with 150mg.
BEST WISHES
Willow
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