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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Toast on October 28, 2002, at 11:49:25
I have had panic attacks for many years, accompanied by bruxism (this is non SSRI induced). I guess its just from being really stressed out. I am knew to the medication world and am trying to find things that work.
I am currently on Buspirone - 15mg, twice a day - and was on .5mg Clonazepam at night. The past two nights I upped the dozage to 1.5mg Clonazepam. I still haven't seen much luck with getting rid of the bruxism. I do wear a night guard and that helps with the headaches, etc. It seems to be a stubborn case of bruxism.
My panic attacks basically revolve around upset stomach. When I get worried, (crowds, tight places, so forth) I get really upset stomach, many times to the point of vomiting.
Anyone have any advice for either the panic attacks or the bruxism?
Thanks,
Toast
Posted by Mr Cushing on October 28, 2002, at 15:04:23
In reply to Bruxism, Clonazepam, Buspar, posted by Toast on October 28, 2002, at 11:49:25
For the panic attacks, instead of taking your 1.5mg of Clonazepam all in one dose, try dividing the doses up during the day. Like for example, take .5 in the morning, .5 sometime in the afternoon, and another .5 before bed. That should allow you to continue a smooth flow throughout the entire day.All I know is that I'm Bi-Polar and I was in the middle of a very lengthy manic episode when I was put on Clonazepam. That's the way that I was told to take it, and I haven't had a panic attack now since I started.
Posted by Toast on October 28, 2002, at 16:25:51
In reply to Re: Bruxism, Clonazepam, Buspar, posted by Mr Cushing on October 28, 2002, at 15:04:23
> All I know is that I'm Bi-Polar and I was in the middle of a very lengthy manic episode when I was put on Clonazepam. That's the way that I was told to take it, and I haven't had a panic attack now since I started.Thats great, what kind of medication schedule are you on? I started taking it all at once to see if I could stop the bruxism, now for the panic attacks I can see why it wuold be best to divi it out.
Posted by jflange on October 28, 2002, at 17:47:50
In reply to Bruxism, Clonazepam, Buspar, posted by Toast on October 28, 2002, at 11:49:25
Toast:
I was intrigued by your post because I experience some of the same symptoms (bruxism and panic-induced upset stomach).
I think the BuSpar and the clonazepam are a good start, but I really do believe that if panic disorder is the issue you are trying to address with medication, you might want to think of adding an SSRI at some point. BuSpar has its charms as a monotherapy to address persistent, low-grade anxiety (also in tandem with a benzo as you are doing), but it has been a much more effective treatment for me as a supplement for Zoloft in my case. This is especially true for the panic-related stomach problems. I never found BuSpar alone (or with a benzo) to be truly helpful for this... and anyway, I don't think BuSpar even has the indication for panic disorder, just for GAD. At the same time, I found taking an SSRI alone tended to exacerbate that anxious queasiness. I tried a few of them but never Paxil, which some say works well for panic. But now I have been very pleased with the BuSpar + Zoloft regimen, and recommend it highly for the symptoms you describe.
As for the bruxism, I just dropped some money for the hard (not soft) nightguard from my dentist. It apparently trains the jaw not to clench. I have never found that benzos alleviate it!! Too bad.
jflange
Posted by IsoM on October 28, 2002, at 18:54:06
In reply to Bruxism, Clonazepam, Buspar, posted by Toast on October 28, 2002, at 11:49:25
About bruxism: Not everyone can do this so don't feel bad if you can't, but I've trained myself to be aware of when I clench my jaw muscles tight. I do it during the day too, not just at night, so it makes it easier to be aware of. I can clench my jaw muscles tight till they ache without even pressing my teeth together. As soon as I'm aware of it, I let my jaw sag. I may need to do it dozens of times a day at first. I can sag & then go back to clenching in a minute or two. But by persisting & keeping at it, after a week or so, you'll find you're rarely doing it. Mind you, the muscle tension or energy has to come out somewhere, so I fidget & squirm a lot, but I don't mind.
Are you sure the Buspar is helping? It works great for many people but for some, it can increase muscle tension & anxious feelings.
Do you only get an upset stomach when you become anxious or worried. If life is completely calm with no outside influences, will your stomach ever be upset then? The reason I'm asking is because IBS (irritable bowel syndrome) can tie in with neurotransmitter problems. It's considered sort of the digestive equivalent of a migraine. There's nothing structually wrong with the digestive system but the nerve messages can get mixed & instead of smooth muscle action resulting, it can spasm. A person can get a range of symptoms from excessive gas, stomach cramps, diarrhea, constipation, nausea (& vomitting) all the way to very severe pain. Is it possible you have IBS & stress causes it to flair up?
IBS tends to run in families. I have it & two sons do too. My stomach behaves most of the time, but if I feel sick from too much stress (especially when a situation feels hopeless to me), my IBS flairs right up. It has nothing to do with diet or viruses, just stress. I have medication for such times as this but it's not something you can get in the States. It's a calcium-channel blocker designed for IBS that's available by prescription only in Canada (called Dicetel). But if you live here, it may be worth taking to your doctor about it.
Mr Cushing's advice about clonaepam is sound & it should help make panic attacks milder & hopefully, less frequent. There are other medications that can help with both the anxiety (panic attacks) & the bruxism together such as certain SSRIs.
Posted by Toast on October 28, 2002, at 20:34:38
In reply to Re: Bruxism, Clonazepam, Buspar, posted by jflange on October 28, 2002, at 17:47:50
Jflange, Thanks for the advice. You are the second person I know of who has had success calming an anxious stomach with Zoloft. I will ask my dr. about it. I haven't tried an SSRI yet, I wonder why my doc hasn't prescribed it. I've got the soft mouth guard now, I can really chomp on it but at least I don't have headaches. I can live with that I suppose as long as I can get rid of the upset stomach! Glad to hear you've had some success. Mine mostly comes in social situations, would be nice to feel a little more comfortable around people.
Thanks,
Toast
Posted by Toast on October 28, 2002, at 20:45:08
In reply to Re: Bruxism, Clonazepam, Buspar » Toast, posted by IsoM on October 28, 2002, at 18:54:06
IsoM,
> About bruxism:
I am a chronic nail biter so I know what you mean. I have been able to cut way down on biting my nails, tough habit to break but over the past few years I have done a much better job at it.
> Are you sure the Buspar is helping? It works great for many people but for some, it can increase muscle tension & anxious feelings.I think it is helping me. I just think the effects are so small I'm not sure that it is helping out enough. It's kinda hard to say.
>
> Do you only get an upset stomach when you become anxious or worried. If life is completely calm with no outside influences, will your stomach ever be upset then? The reason I'm asking is because IBS (irritable bowel syndrome) can tie in with neurotransmitter problems.I would say this is definitely IBS related. Whenever I get highly stressed out my stomach gets upset. This makes me want to be shy away from people. So if I have a lot of food in my stomach, it tends to make me almost agorophobic because I am afraid I will get sick in front of people, which has happened in the past. But get me on an empty stomach and I can do just about anything I want with relatively little anxiety. Have you had pretty good success then with the meds you have now? I live in the US, I wonder what kind of availability if any there is here.
Thanks,
Toast
Posted by Simcha on October 29, 2002, at 0:34:10
In reply to Bruxism, Clonazepam, Buspar, posted by Toast on October 28, 2002, at 11:49:25
Currently I'm on 1mg of Clonazepam at night for bruxism. It works but my pdoc wants me to consider switching to Topamax or Neurontin for the Bruxism. I'm not sure these meds will work yet he has made some strong arguments against using the Clonazepam for a long-term solution.
I don't know. I'm on this journey like everyone else. I'm hoping for the best.
Simcha
> I have had panic attacks for many years, accompanied by bruxism (this is non SSRI induced). I guess its just from being really stressed out. I am knew to the medication world and am trying to find things that work.
>
> I am currently on Buspirone - 15mg, twice a day - and was on .5mg Clonazepam at night. The past two nights I upped the dozage to 1.5mg Clonazepam. I still haven't seen much luck with getting rid of the bruxism. I do wear a night guard and that helps with the headaches, etc. It seems to be a stubborn case of bruxism.
>
> My panic attacks basically revolve around upset stomach. When I get worried, (crowds, tight places, so forth) I get really upset stomach, many times to the point of vomiting.
>
> Anyone have any advice for either the panic attacks or the bruxism?
>
> Thanks,
> Toast
Posted by Toast on October 29, 2002, at 8:18:39
In reply to Re: Bruxism, Clonazepam, Buspar » Toast, posted by Simcha on October 29, 2002, at 0:34:10
> Currently I'm on 1mg of Clonazepam at night for bruxism. It works but my pdoc wants me to consider switching to Topamax or Neurontin for the Bruxism. I'm not sure these meds will work yet he has made some strong arguments against using the Clonazepam for a long-term solution.
>
> I don't know. I'm on this journey like everyone else. I'm hoping for the best.
>
> Simcha
Simcha,I read some of your posts from the beginning of the year when you first started taking Klonopin. That was one of the things that encouraged me to take it. I have noticed an improvement when I take 1.5 mg vs .5 mg but still doesn't wipe it out completely. But after reading some other posts I am considering asking my doc about taking an SSRI. I wonder if its a good idea to take 2 meds that can cause dependancy (SSRI and Benzo). I guess I'll just ask my doc. So are you going to switch to one of the other meds? Are they in the Benzo family also?
Thanks,
Toast
Posted by jflange on October 29, 2002, at 20:39:59
In reply to Re: Bruxism, Clonazepam, Buspar » jflange, posted by Toast on October 28, 2002, at 20:34:38
Toast:
Yep, I have had the same problems with social situations and everything from a crowded restaurant/ movie theatre to riding the subway made me have all this anticipatory dread about throwing up in a crowd. And as you say, the worst is after eating a big meal... I think it must trigger some kind of panic response in the brain.
When I took BuSpar alone, I found it was helpful but somehow never >completely<, while Zoloft has really done a lot of good for me in terms of motivation and overcoming some of the social anxiety that had developed from weeks, months of feeling at the mercy of my gut (!). There's a lot to be said for that "well, whatever" attitude one gets from ssris! I too was definitely reluctant at first to take these meds for this condition, and the truth is, Zoloft made the anxiety/ nausea worse for a short time in the beginning (this may be why your doc has not rushed to rx it to you). But this indeed did fade after a few weeks or so and now my general sense is that the side-effects and dependency issues from the meds are minimal compared to the deleterious effects of anxious quease.
Oh, and I still only eat little meals just to be on the safe side. ;) Best of luck,
jflange
> Jflange, Thanks for the advice. You are the second person I know of who has had success calming an anxious stomach with Zoloft. I will ask my dr. about it. I haven't tried an SSRI yet, I wonder why my doc hasn't prescribed it. I've got the soft mouth guard now, I can really chomp on it but at least I don't have headaches. I can live with that I suppose as long as I can get rid of the upset stomach! Glad to hear you've had some success. Mine mostly comes in social situations, would be nice to feel a little more comfortable around people.
>
> Thanks,
> Toast
>
>
Posted by Toast on October 30, 2002, at 10:32:23
In reply to Re: Bruxism, Clonazepam, Buspar, posted by jflange on October 29, 2002, at 20:39:59
> Toast:
>
> Yep, I have had the same problems with social situations and everything from a crowded restaurant/ movie theatre to riding the subway made me have all this anticipatory dread about throwing up in a crowd. And as you say, the worst is after eating a big meal... I think it must trigger some kind of panic response in the brain.
>
> When I took BuSpar alone, I found it was helpful but somehow never >completely<, while Zoloft has really done a lot of good for me in terms of motivation and overcoming some of the social anxiety that had developed from weeks, months of feeling at the mercy of my gut (!). There's a lot to be said for that "well, whatever" attitude one gets from ssris! I too was definitely reluctant at first to take these meds for this condition, and the truth is, Zoloft made the anxiety/ nausea worse for a short time in the beginning (this may be why your doc has not rushed to rx it to you). But this indeed did fade after a few weeks or so and now my general sense is that the side-effects and dependency issues from the meds are minimal compared to the deleterious effects of anxious quease.
>
>
> Oh, and I still only eat little meals just to be on the safe side. ;) Best of luck,
> jflange
jflange,Sounds like you are doing pretty well then. How are your avoidance levels now? Would you say you are fairly close to leading a "normal" life (whatever that is)? Also, are you planning on eventually trying to get off the meds? I think our guts have a lot in common.
Thanks,
Toast
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