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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by Simcha on October 20, 2002, at 12:49:13
Are you on Neurontin? If so, what are you taking it for? Does it work? What are the side-effects?
I'm having to make a decision about med changes soon so any info would be greatly appreciated.
Thanks,
Simcha
Posted by Jason Dicks on October 22, 2002, at 13:31:52
In reply to Is anyone on Neurontin these days?, posted by Simcha on October 20, 2002, at 12:49:13
I was on Neurontin for years up until recently. It decreased the severity of my social anxiety, which is why it was perscribed for me.
I stopped taking Neurontin for money reasons, and I suffered indeed. During withdrawal, it became appearant how well it had been smoothing over the rough edges of my paranoia to allowe me to move on with my life. The benefits were not as observable as those I got from Klonapin however. I would recommend Klonapin over Neurontin for anyone with social anxiety.
Posted by viridis on October 23, 2002, at 3:00:58
In reply to Re: Is anyone on Neurontin these days?, posted by Jason Dicks on October 22, 2002, at 13:31:52
I'm on it (1200 mg/day), although I'm not sure it has much effect -- Klonopin and Adderall are my "keystone" meds for anxiety/depression/ADD. My pdoc feels that it provides additional "subtle stability", and his intuition has proven very good so far. So, I'm sticking with it for now (my insurance is pretty good, so it doesn't cost me much, plus it will soon go generic -- already is in Canada). It has no side effects for me, so seems OK so far.
Posted by Rick on October 24, 2002, at 23:22:01
In reply to Re: Is anyone on Neurontin these days?, posted by viridis on October 23, 2002, at 3:00:58
> Klonopin and Adderall are my "keystone" meds for anxiety/depression/ADD.
I'm curious...As far as the social anxiety part of your treatment goes, do you think the Adderall offsets some of the Klonopin benefit; adds to it; or neither?
Also, what exactly is your regimen -- dosages, times, etc.
Finally, have you used any other stimulants and found that they worsened your social anxiety (or helped less)?
Thanks,
Rick
Posted by Rick on October 24, 2002, at 23:27:08
In reply to Re: Is anyone on Neurontin these days?, posted by Jason Dicks on October 22, 2002, at 13:31:52
I find Klonopin hugely beneficial for my social anxiety. I tried Neurontin with no benefit (and it started causing anorgasmia at the high doses).
I didn't give it a very long trial, though.
How long did it take to start working for you? Also, how much were you taking, and at what times?
Any side effects?Thanks,
Rick
> I was on Neurontin for years up until recently. It decreased the severity of my social anxiety, which is why it was perscribed for me.
>
> I stopped taking Neurontin for money reasons, and I suffered indeed. During withdrawal, it became appearant how well it had been smoothing over the rough edges of my paranoia to allowe me to move on with my life. The benefits were not as observable as those I got from Klonapin however. I would recommend Klonapin over Neurontin for anyone with social anxiety.
Posted by viridis on October 26, 2002, at 1:25:11
In reply to Re: Is anyone on Neurontin these days? » viridis, posted by Rick on October 24, 2002, at 23:22:01
Hi Rick,
My "official" diagnoses are panic disorder, major depression, and ADD. There's probably some social anxiety mixed in there; like the panic attacks, that's sporadic, but without meds I have a high level of general anxiety much of the time. The pattern before meds was a regular buildup of worry, ruminating thoughts, and insomnia, sometimes precipitating periods of panic attacks and often causing a crash into severe depression. I've experienced this for as long as I can remember (30+ years), even as a child.
I've had various rounds of treatment with SSRIs (sometimes for months at a time) and respond very badly to this class of meds -- increased anxiety, insomnia, bizarre mood swings, and various other side effects that don't subside over time. I refuse to take SSRIs now, and my current pdoc agrees that they're not appropriate for me.
When I started Klonopin, my overall anxiety level dropped drastically. I also took a fair bit of Xanax at first, but rarely use it any more. I have plenty of Xanax, but reserve it for occasional, very stressful situations.
I started with 1 mg/day of Klonopin; my pdoc offered to increase the dose if necessary, but 1 mg works very well and has continued to do so after over well over a year. I tried various dosing schedules early on. I did have some initial drowsiness/ clumsiness/ forgetfulness, but that subsided after a couple of weeks. Initially I tried 1 mg before bed, but found that the anti-anxiety effect wore off by mid-morning. Then I tried 0.25 mg 4X/day, then 0.50 mg 2X/day, but quickly settled on the whole 1 mg in the morning once the initial side effects disappeared.
Klonopin alone (plus occasional Xanax) greatly reduced my anxiety and eliminated the severe depression that results from anxiety. However, I still had some depression on and off, and continued to have problems with focus. I'd been tentatively diagnosed with ADD twice before, and my pdoc picked up on this too. After a lot of questioning, he concluded that I fit the criteria for ADD and suggested addition of a psychostimulant. I tried 50-100 mg Provigil/day for a while. It was OK -- stimulating without causing anxiety -- but didn't really help with the focus problems. I also experimented with addition of various (low) doses of Wellbutrin. I'd taken this before without benzos and found it very anxiogenic, but thought that maybe with the benzos it would be alright. It provided stimulation but was just irritating and didn't help, so I abandoned that.
Then my pdoc prescribed Adderall (about 10 months ago). It's been very helpful, and seems to work synergistically with the Klonopin. Although some stimulants (such as caffeine) can make me feel "wired", amphetamines have a calming, focusing effect at low doses for me. Adderall also relieved most of the depression that remained (although Klonopin had already reduced the severity of my depression greatly). I take 5 mg of Adderall every morning, along with 1 mg Klonopin, and often take another 2.5-5 mg Adderall a few hours later. So far I haven't needed to increase the dose of either, and they continue to provide the same benefits as they did initially.
Then there's Neurontin. I suggested it early on, and my pdoc agreed that it might help with mood stability (although he considers it a very "mild" mood stabilizer). I take 1200 mg/day in three 400 mg doses, and it has no side effects. Maybe it's helping, but I'm quite sure that Klonopin and Adderall are the key meds. However, my pdoc suggests I stay with Neurontin for now, as he suspects it adds "background" stability. Since things are going well, I'm sticking with this combo for the time being, although I may try dropping the Neurontin at some point.
So my dosing regimen is 1 mg K in the AM along with 5 mg Adderall and 400 mg Neurontin, then often 2.5-5 mg Adderall in the afternoon and two more 400 mg doses of Neurontin at about 5-6 hour intervals. As I mentioned, I occasionally take 0.25-0.50 mg Xanax (maybe once every week or two on average).
I hope this is helpful,
Viridis
Posted by Simcha on October 26, 2002, at 10:41:02
In reply to Re: Is anyone on Neurontin these days? » Rick, posted by viridis on October 26, 2002, at 1:25:11
Thanks, everyone for their responses to this thread. I'm learning a lot about Neurontin. I'm wondering if my pdoc might be leaning toward Neurontin and Topamax because he might think that I'm slightly bipolar... I'm still waiting for my old pdoc to transfer records to this current pdoc.
Take Care,
Simcha
Posted by Rick on October 26, 2002, at 15:57:57
In reply to Re: Is anyone on Neurontin these days? » Rick, posted by viridis on October 26, 2002, at 1:25:11
Yes, Viridis, it was quite helpful! Thanks for providing such a detailed, clear response. But leave it to me to still manage to have some followup questions:
1) Do you experience any kind of crashing effect when the Adderall wears off?
2) Would you guess that in someone without ADD,
Adderall might be more likely to produce a wired effect instead of a calming one -- even in tandem with Klonopin?
3) If you have checked, have you noticed any effect of Adderall on blood pressure or heart rate?I don't believe I have ADD, although sometimes I wonder...
Thanks again,
Rick
Posted by viridis on October 27, 2002, at 1:14:34
In reply to Re: Is anyone on Neurontin these days? » viridis, posted by Rick on October 26, 2002, at 15:57:57
Hi Rick,
No, I don't experience any crash, but then my dose of Adderall is very low. It just seems to wear off gradually (and I'm taking the generic, non-sustained-release version). By the way, I can take it any time of the day and it has no effect on my ability to sleep.
I'm not sure what it would do in someone without ADD; my guess is that the effects would be highly variable, but this is purely speculation. I gather it's fairly popular as a party drug, but I can't imagine using it that way; two 5 mg doses spaced too closely is just annoying for me (at this level it becomes stimulating, not terrible but no longer helpful either). Adderall seems to have a very narrow window of utility for me, but it's great within that window.
Re: bp etc.: my bp is generally normal on Adderall (typically 120-something over 80-something), unless it's taken by a medical professional, in which case it skyrockets whether I'm on Adderall or not. I'm very uneasy in doctors' offices (always have been) and am a classic "white-coat syndrome" type. As soon as they put that cuff on I can feel my blood pressure rise. If I take it myself, there's no problem, and if they take it again it drops drastically. So, I always have to get at least two bp readings in a doctor's office. But this has nothing to do with Adderall. Again, the dose I'm on is considered very low, but it works for me.
I respond best to low doses of the psychiatric meds I've tried (except Neurontin, with which I could probably take any amount, and SSRIs, which freak me out at any dose). My tolerance for non-psychiatric meds is normal, and I don't have any weird allergies, non-psychiatric medical conditions, etc.
This is the end of the thread.
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