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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by LLL on August 14, 2002, at 12:28:34
I am acutely sensitive to all medicines. I cannot tolerate the increased anxiety and panic that SSRI's cause. After 12 days on the lowest dose of Parnate - could not handle the intense sedation which is a rare side effect and didn't happen to me before while on it. If you're thinking "well, what's wrong with a little sedation", I cannot explain to you how this feels (and still does) but I HATE IT and I'm anxious about it. It's not like "just being sleepy" it's this 24 hr. "sinking" feeling that I cannot aptly describe and has caused me to have increased anxiety since I can't STOP IT! Considered trying Celexa, although I have a terrible history on SSRI's, but after reading through many posts on it am sufficiently scared to death to try it. Seems that almost eveyone had increased anxiety initially plus ended up being really tired during the day and not sleeping at night - NO THANKS!
Are there any food or drug supplements out there that could be of benefit if I also tried using Klonopin supplemented with occasional low doses of xanax?
There HAS to be alternatives to antidepressants.
Any advice or experience with this would be most appreciated.
Thanks,
Lisa
Posted by Ritch on August 14, 2002, at 13:38:49
In reply to Alternatives to AD's for Panic/Agoraphobia????, posted by LLL on August 14, 2002, at 12:28:34
> I am acutely sensitive to all medicines. I cannot tolerate the increased anxiety and panic that SSRI's cause. After 12 days on the lowest dose of Parnate - could not handle the intense sedation which is a rare side effect and didn't happen to me before while on it. If you're thinking "well, what's wrong with a little sedation", I cannot explain to you how this feels (and still does) but I HATE IT and I'm anxious about it. It's not like "just being sleepy" it's this 24 hr. "sinking" feeling that I cannot aptly describe and has caused me to have increased anxiety since I can't STOP IT! Considered trying Celexa, although I have a terrible history on SSRI's, but after reading through many posts on it am sufficiently scared to death to try it. Seems that almost eveyone had increased anxiety initially plus ended up being really tired during the day and not sleeping at night - NO THANKS!
> Are there any food or drug supplements out there that could be of benefit if I also tried using Klonopin supplemented with occasional low doses of xanax?
> There HAS to be alternatives to antidepressants.
> Any advice or experience with this would be most appreciated.
> Thanks,
> Lisa
Lisa,What might work best for you is a relatively non-sedating benzodiazepine. Klonopin can be *very* tiring, we know what you mean. I believe we had a thread running here about "non-sedative" benzos and I think that oxazepam got mentioned quite a bit.
hope this helps some,
Mitch
Posted by LLL on August 14, 2002, at 14:10:34
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » LLL, posted by Ritch on August 14, 2002, at 13:38:49
Mitch,
That sounds interesting, what brand name does oxazepam go by? I find I can use xanax but it's short acting and couldn't imagine taking it round the clock without getting really sleepy (not the same feeling I'm having now though from the Parnate, which is quite yukky).
Please let me know.
Thanks,Lisa
Posted by Ed O`Flaherty on August 14, 2002, at 16:30:58
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » Ritch, posted by LLL on August 14, 2002, at 14:10:34
I reported on a case of a woman who got good relief from agoraphobia and panic attacks in www.omega3.20megsfree.com
Posted by LLL on August 14, 2002, at 19:46:41
In reply to Re: Alternatives to AD's for Panic/Agoraphobia????, posted by Ed O`Flaherty on August 14, 2002, at 16:30:58
Can I begin the fish oil before the MAOI wash out period? which I believe is 2 weeks? or is it 4?
Thanks,
Lisa
Posted by judy1 on August 14, 2002, at 20:02:52
In reply to Alternatives to AD's for Panic/Agoraphobia????, posted by LLL on August 14, 2002, at 12:28:34
Hi Lisa,
I have panic disorder and take klonopin and xanax prn for it- they work extremely well. Are you saying you feel tired on klonopin? Have you played with the dose? I agree xanax is difficult to take around the clock (although a lot of people do) but prn is perfect. I've tried fish oil (omegabrite) for bipolar disorder- it had no effect on my panic at all. Benzos are the treatment of choice for panic, and klonopin is usually the one indicated. My pdoc who specializes in panic, never prescribes ADs. Hope this helps- judy
Posted by LLL on August 14, 2002, at 20:06:56
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » LLL, posted by judy1 on August 14, 2002, at 20:02:52
Posted by LLL on August 14, 2002, at 20:22:12
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » LLL, posted by judy1 on August 14, 2002, at 20:02:52
Judy, by the way, do you have agoraphobia? If so, do you find the Klonopin helps you through the anticipatory anxiety when having to do things or go places outside your "safe area"?
Thanks,
Lisa
Posted by tina on August 14, 2002, at 22:11:07
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » judy1, posted by LLL on August 14, 2002, at 20:22:12
In my case, klonopin does help with the anticipatory anxiety. However, it still makes me sleepy but I'd rather be sleepy than panic-ing.
good luck
t
Posted by LLL on August 14, 2002, at 22:29:31
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » LLL, posted by tina on August 14, 2002, at 22:11:07
My anxiety disorder makes me afraid of the effects of med's I haven't yet taken so I'd like to ask, how long does one dose of Klonopin last? Do you feel "just sleepy" or is it some type of weird sedated feeling (what I've been experiencing the last few days on Parnate, but have since stopped)? Are you able to go and do things you're apprehensive about doing? Sorry for all the questions. Any input would be appreciated.
Lisa
Posted by Dinah on August 14, 2002, at 23:32:34
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » tina, posted by LLL on August 14, 2002, at 22:29:31
Just speaking for myself, Klonopin not only doesn't make me sedated, but it doesn't even make me sleepy. It just takes away the anxiety.
But everyone reacts differently to these drugs. So as always, your mileage may vary.
Posted by Ritch on August 14, 2002, at 23:34:23
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » Ritch, posted by LLL on August 14, 2002, at 14:10:34
> Mitch,
>
> That sounds interesting, what brand name does oxazepam go by? I find I can use xanax but it's short acting and couldn't imagine taking it round the clock without getting really sleepy (not the same feeling I'm having now though from the Parnate, which is quite yukky).
>
> Please let me know.
> Thanks,
>
> Lisa
>Lisa,
Oxazepam is available as a generic, but I think the patented tradename is Serax, it has about twice the halflife of Xanax (approx. 8hrs instead of approx. 4hs). You would still need to dose 2-3x daily with it for good coverage.
Mitch
Posted by LLL on August 14, 2002, at 23:39:32
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » LLL, posted by Ritch on August 14, 2002, at 23:34:23
Mitch,
What does it feeeeel like? I don't want to be trapped for 8 hours on a ride I don't like! I took Klonopin a long time ago and only remember it making me feel like a depressed zombie (and I'm not depressed). I don't remember the dose and can't even remember if it helped my anxiety, I only remember not feeling well on it.
If you don't mind my asking, how does it effect you?Thanks,
Lisa
Posted by judy1 on August 14, 2002, at 23:46:48
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » judy1, posted by LLL on August 14, 2002, at 20:22:12
and the only thing that helps me with that is therapy. the klonopin/xanax stop the panic attacks- especially xanax sub-ling if it's a really bad one. i was thinking perhaps ativan might be helpful- another 8 hour benzo. yes, depression does occur in some people who take klonopin, i'm sorry you are one of them. xanax is pretty uplifting though, so maybe an ativan/xanax combo would help you. take care, judy
Posted by alan on August 15, 2002, at 0:58:59
In reply to oh do i ever have agoraphobia » LLL, posted by judy1 on August 14, 2002, at 23:46:48
I'm on klon and ativan. I've had different reactions to each and every bzd alone and in combo. Valium and tranxene can be added to the list of longer acting bzds.
A lot of testing and playing around with dosages and types. That's the great thing about this class of meds...no waiting around for results. My doc specialises in treating the anxiety disorders and gets almost uniformly good results with this class. If you get overstimulated by the AD's just forget about them. You just have to experiment and have a doc that will give you the latitude to do what works.
Good luck!
Alan
Posted by Mr. Scott on August 15, 2002, at 4:09:16
In reply to oh do i ever have agoraphobia » LLL, posted by judy1 on August 14, 2002, at 23:46:48
Tranxene and Serax are both only mildy sedating. Tranxene is around the clock 16 hr duration benzo & Serax is a 3-4 time a day one. Maybe those might help?
Posted by LLL on August 15, 2002, at 9:13:03
In reply to Re: oh do i ever have agoraphobia, posted by alan on August 15, 2002, at 0:58:59
Posted by Ritch on August 15, 2002, at 10:01:25
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » Ritch, posted by LLL on August 14, 2002, at 23:39:32
> Mitch,
>
> What does it feeeeel like? I don't want to be trapped for 8 hours on a ride I don't like! I took Klonopin a long time ago and only remember it making me feel like a depressed zombie (and I'm not depressed). I don't remember the dose and can't even remember if it helped my anxiety, I only remember not feeling well on it.
> If you don't mind my asking, how does it effect you?
>
> Thanks,
> Lisa
Lisa,I was just providing some technical info about Serax. I brought it up originally because of a previous thread we had here about "non-sedative" benzos and it seemed to be mentioned by several other posters. I have never personally taken Serax. The "non-sedative" benzo I "voted" for which I had taken was Librium. I don't think you ever mentioned anything about *not* liking Xanax. If it works well for your panic, have you considered just taking Xanax as a regimen every 4-6hrs? In other words, taking Xanax 4x daily regardless of how you feel? As far as MAOI's go, I think Mr. Scott's suggestion about Nardil (instead of Parnate) is a great idea. Nardil is supposed to be the "gold standard" for social anxiety, and one might think that could be very helpful for your agoraphobia. It also is very effective for panic. The "weirdness" you feel on the Parnate might not be experienced with Nardil. Just some thoughts,
Mitch
Posted by LLL on August 15, 2002, at 10:13:51
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » LLL, posted by Ritch on August 15, 2002, at 10:01:25
Thanks Mitch,
I began on Nardil back in the mid-90's and switched to Parnate (without any problem) due to side effects (not weirdness or anything but other unpleasant physical stuff). I think I'm going to try some low dose Klonopin and mega-vitamin therapy with Omega 3 and GABA and the addition of St.John Wort and therapy.
Thanks so much for your help.Lisa
Posted by tina on August 15, 2002, at 11:56:32
In reply to Re: Alternatives to AD's for Panic/Agoraphobia???? » tina, posted by LLL on August 14, 2002, at 22:29:31
Lisa
My klonopin dose lasts all day. I take 0.5 mgs every morning and every night. It does help me do things that I"m normally apprehensive about. The sleepiness is just general lethargy and not being able to keep my eyes open but that only happens when I take more than I really need.
I've never felt "stoned" or weird though. Just sleepy.
take care
tina
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