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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 hildi on May 17, 2003, at 10:11:59
I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
Hildi
Posted by johnj on May 17, 2003, at 12:08:10
In reply to nortryptline affect on anxiety, posted by hildi on May 17, 2003, at 10:11:59
Hi
I am not bipolar, but have been on nortyptline for over 10 years. I have trouble with side effects so I can only take 50 mg. I was originally on 100 mg and was having lots of trouble. Went down to 50 and added 600 mg of litium and became pretty clear. Also took tranzene, a benzo, 15 mg daily. I don't think norty caused more anxiety, but it helped my sleep greatly. I have come to the time when things are not working as well so I am looking for something different. Personally, I tried one ssri and couldn't take the anxiety. I believe anxiety is very strong in my illness.
People here have tried some supplements like Magnesium to help sleep and anxiety. It helped me but after 10 days my sleep was disturbed.
Are you on a mood stabilizer?(lithium).
You will also see posts about people taking nortrptline AND an ssri. One option I have been thinking is Celexa for myself, but ssri scare me. Hope things go well. A TCA is worth a shot. If I could get something to last for 10 years at a time I would be happy.
Also, with nortryptline I have had little, if any, sexual dysfunction. Dry mouth and urinating can be problematic though. Good luckjohnj
Posted by jay on May 17, 2003, at 14:56:42
In reply to nortryptline affect on anxiety, posted by hildi on May 17, 2003, at 10:11:59
I had an excellent experience with Brand name nortiptyline (Aventyl in Canada). But the best effect was a high dose benzodiazepine with a small, small dose of nortiptyline. I'd suggest you give it a shot. Good luck.
Jay
Posted by zeugma on May 17, 2003, at 18:15:38
In reply to nortryptline affect on anxiety, posted by hildi on May 17, 2003, at 10:11:59
> I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
>
> I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
> Hildi
Hi Hildi,Good to see you back here- I'm still taking nortriptyline, last week I took the HAM-D depression test and compared it with my scores from before I started the med- my depression was in total remission. The thing about nortriptyline is about dosage and metabolism. I read a study in which they monitored blood levels of nortriptyline and its metabolite, and they found that those with higher percentages of this metabolite had greater efficacy and fewer of the side effects johnj was talking about- like dry mouth and difficulty urinating. Here's an old Babble post about this: http://www.dr-bob.org/babble/20010530/msgs/65245.html
The trick is, you can't know in advance what your genomic status is so you'll have to see what kind of s/e you'll have. The side effects I have at this point (75 mg/day) are minimal. I just get tired at night a few hours after I take it, with the result that waking up in the morning is a lot easier.And nortriptyline has a therapeutic window which may make a blood levels test necessary at some point- that was how I arrived at an optimal dose.
About the bipolar_ yes, I've heard that TCA's are not great for bipolars; are you currently taking a mood stabilizer or lithium? You could add on nortriptyline to that instead of an SSRI and see what happens.
I'd say nortriptyline is worth a try and it definitely has a different 'flavor' than the SSRI's. But a lot depends on factors about your metabolism you can't know in advance. In other words- you need some luck.
z
Posted by zeugma on May 17, 2003, at 18:39:48
In reply to nortryptline affect on anxiety, posted by hildi on May 17, 2003, at 10:11:59
I just started on Strattera this week, so I don't know what its long-term effects will be. It's like a "new-generation" TCA in its mechanism, giving a pure NE-reuptake inhibition effect and has no anticholinergic effects to worry about. And it's a lot more simple in terms of its metabolism than nortriptyline so presumably its effects should be more predictable. Maybe you could try this instead (at a very low dose to begin with) to see if you prefer an NE-active drug over the serotonin ones?
Posted by hildi on May 18, 2003, at 15:35:36
In reply to p.s. there's also Strattera, posted by zeugma on May 17, 2003, at 18:39:48
> I just started on Strattera this week, so I don't know what its long-term effects will be. It's like a "new-generation" TCA in its mechanism, giving a pure NE-reuptake inhibition effect and has no anticholinergic effects to worry about. And it's a lot more simple in terms of its metabolism than nortriptyline so presumably its effects should be more predictable. Maybe you could try this instead (at a very low dose to begin with) to see if you prefer an NE-active drug over the serotonin ones?
Hi. I'm worried about taking an ad that works on NE reuptake, especially one that has STRONG effects on NE reuptake, because I think that 'may' cause more anxiety in me. With effexor and with wellbutrin I had bad reactions- don't both of those have NE reuptake properties?
With the two mentioned above I had really wierd feelings. l I am really sensitive. For instance, when I go to the dentist I have to tell them not to put any noreprenephrine (sp?) in my novocaine because if they do I have panic attacks, practically have a heart attack with the anxiety.
Which would have the LEAST NE reuptake effects-strattera or Nortryt?
I just started lexapro (after a bad experience with celexa, so why the dr insists I go on this med, which is basically the same as celexa, but stronger, is beyond me.) I feel the same old crude. Sea sick feeling, anxiety, shaky, numb-brain sort of feeling. I've also been on prozac and zoloft. All the same kind of numb, sick feelings. But there is 'some' anxiety relief-but it's wierd- because it helps with some anxiety, but brings on a whole different type of anxiety that I can't explain. Very strange. Paxil is another SSRI I tried- and although it is promoted for anxiety I had the most anxiety on paxil than any other- I was a horrible mess, crying uncontrollably, severe anxiety attacks, etc . .
In response to your other post- I have only tried one mood stabilizer: depakote, but it made me feel more manic than ever. I ask my dr to try me on another, and he says the depokote is the best, so he won't consider another. "On the side" though, I did try neurontin, made me giddy and feeling high, no mania relief. Right now I'm also on a low dose clonazepam/klonopin, which practically does nothing for the anxiety at the doses prescribed but does seem to help a bit with the mania- but this is if I take larger doses than prescribed. Dr. won't put me on higher dose for fear of drug dependency.
So, day three of lexapro and I am thinking of ditching it. Why would this work if celexa didn't? Also, I feel that same sick feeling like I have from the prozac and zoloft.
I really don't know what to think- meds that promote anxiety relief don't work for me, so maybe a more activating one would? Maybe it was all the other things in the wellbutrin and effexor that caused the bad reactions, not just the NE reuptake alone?
I am needing to find out more about what receptors both nortrypt and strattera work on.
I also am going to have to find another doc- this guy refuses to even discuss TCA's and I don't think he will be open to strattera, either.
Hildi
PS: Are you taking both meds: nortryp and strattera, or did you stop the nortry?
Posted by hildi on May 18, 2003, at 15:39:49
In reply to Re: nortryptline affect on anxiety » hildi, posted by johnj on May 17, 2003, at 12:08:10
> Hi
>
> I am not bipolar, but have been on nortyptline for over 10 years. I have trouble with side effects so I can only take 50 mg. I was originally on 100 mg and was having lots of trouble. Went down to 50 and added 600 mg of litium and became pretty clear. Also took tranzene, a benzo, 15 mg daily. I don't think norty caused more anxiety, but it helped my sleep greatly. I have come to the time when things are not working as well so I am looking for something different. Personally, I tried one ssri and couldn't take the anxiety. I believe anxiety is very strong in my illness.
> People here have tried some supplements like Magnesium to help sleep and anxiety. It helped me but after 10 days my sleep was disturbed.
> Are you on a mood stabilizer?(lithium).
> You will also see posts about people taking nortrptline AND an ssri. One option I have been thinking is Celexa for myself, but ssri scare me. Hope things go well. A TCA is worth a shot. If I could get something to last for 10 years at a time I would be happy.
> Also, with nortryptline I have had little, if any, sexual dysfunction. Dry mouth and urinating can be problematic though. Good luck
>
> johnjI have been on neurontin and depakote and both made me more manic than ever, I suspect my bipolar tendencies are induced by the SSRI's.
Why are you stopping the nortrypt? You mentioned it is not working anymore? What do you mean- more depressed? more anxious?
Hildi
Posted by hildi on May 18, 2003, at 15:43:14
In reply to Re: nortryptline affect on anxiety » hildi, posted by jay on May 17, 2003, at 14:56:42
> I had an excellent experience with Brand name nortiptyline (Aventyl in Canada). But the best effect was a high dose benzodiazepine with a small, small dose of nortiptyline. I'd suggest you give it a shot. Good luck.
>
> JayWhat benzo did you take along with Aventyl, and how much of each did you take. Also, why did you stop these meds if they were working for you? Side effects? Did you find something better? I am interested, hope you don't mind the probing.
Hildi
Posted by johnj on May 18, 2003, at 18:44:15
In reply to Re: nortryptline affect on anxiety » johnj, posted by hildi on May 18, 2003, at 15:39:49
Hi Hildi:
I would like to stop the norty due to increased insomnia/shallow sleep and the ensuing depression and anxiety that causes. I have various stressors, namely work right now, but in the past I have been able to deal with them and sleep. Funny thing is if I could sleep I could cope. Cause or effect, I have no idea. Now, things are worse than they have been in 10 years or so. Last week was a nightmare. If this is norty poop out, I don't know. But, I am tired of the SE from the TCA's. I am med sensitive and everytime I talk to my boss I lose all saliva and get severe cotton mouth.
Posted by Jackster on May 19, 2003, at 4:02:29
In reply to nortryptline affect on anxiety, posted by hildi on May 17, 2003, at 10:11:59
> I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
>
> I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
> Hildi
Hi HildiI've been on Paxil for years for panic disorder and a while ago it pooped out. One of the drugs my PDoc tried augmenting it with was Nortriptyline. The two interreact, so you only need a small dose of the nortrip to get the therapeutic window. I honestly think it increased my anxiety - despite me being on it for 8 weeks. I think it has to do with the strong NE uptake like you say. If that's the case - then technically Celexa or Paxil would be one of the better meds for you. (Being almost totally serotonin - I think). How long was your trial on these SSRI's - they do tend to be activating at the start - but the idea with panic or anxiety patients is start really low and go slow. There are even liquid forms of these meds to help with this.
Did you try an SSRI with a mood stabiliser? (Sorry I can't remember from your other post).
Anyway - good luck.
Jackie
Posted by zeugma on May 19, 2003, at 15:57:38
In reply to Re: p.s. there's also Strattera » zeugma, posted by hildi on May 18, 2003, at 15:35:36
I'm taking both nortriptyline and Strattera. My dr. thinks that with 75 mg nortriptyline in my system a day, I would only need 25 mg Strattera a day to help with my ADHD- about a quarter of a normal dose. So far (day 6) it seems to be working. My mind feels transparent, not opaque (ADHD is my primary dx and my depression tends to be brought on by ADHD-related crises in my personal life and career).
Nortriptyline from what I can tell is about EQUALLY potent to Strattera- there are similar effective dose ranges for the two drugs. Nortriptyline is a lot less selective, though, also blocking histaminic, cholinergic, alpha-1 adrenergic, and 5-HT 2A receptors. Some of this probably helps anxiety- e.g. histamic block causes sedation, which can help with sleep. In my experience, nortriptyline is like a stimulating drug overlaid woth a sedative, with the sedation slightly predominating, while the Strattera so far seems to be without the sedating component. That's why the Strattera and nortrip seem to be complementary and why I will continue to take both until a reason presents itself not to.
So you didn't like EFfexor or Wellbutrin? I had a terrible time with WB as well- probably an allergic reaction, as I had immediate autonomic CNS side effects. WB however is a drug that seems to cause a LOT of idiosyncratic side effects and dysphoria. And it is by no means a pure NE reuptake inhibitor. Looking thru articles on WB's 'mechanisms of action' reveals convolutions unmatched by any other drug in the armaterarium. What dose Effexor were you on? Effexor at relatively low doses is more of an SRI.
Posted by hildi on May 20, 2003, at 7:30:04
In reply to Re: nortryptline affect on anxiety, posted by Jackster on May 19, 2003, at 4:02:29
> > I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
> >
> > I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
> > Hildi
>
>
> Hi Hildi
>
> I've been on Paxil for years for panic disorder and a while ago it pooped out. One of the drugs my PDoc tried augmenting it with was Nortriptyline. The two interreact, so you only need a small dose of the nortrip to get the therapeutic window. I honestly think it increased my anxiety - despite me being on it for 8 weeks. I think it has to do with the strong NE uptake like you say. If that's the case - then technically Celexa or Paxil would be one of the better meds for you. (Being almost totally serotonin - I think). How long was your trial on these SSRI's - they do tend to be activating at the start - but the idea with panic or anxiety patients is start really low and go slow. There are even liquid forms of these meds to help with this.
>
> Did you try an SSRI with a mood stabiliser? (Sorry I can't remember from your other post).
>
> Anyway - good luck.
>
> Jackie
>Hi. Yes, I've tried depakote and also neurotin; neither helped and actually made me feel more mania. I didn't want to give either of these meds more time or try dose adjustments because of the embarassment my mania was causing me.
I think you're on to something with the NE induced anxiety, but I also think a little of it increases my concentration. For prozac it worked that way for a while, but then the mania I got from it was pretty intense (but totally unlike the nuerotontin or dep), then it made me more OCD and moody. Now when I take prozac, I feel good the first day and feel like a bitch the next.
Now the lexapro I'm on now is all serotonin, and it reminds me of when I was on zoloft: sea-sick feeling and apathy. No increased concentration at all, total lack of it and no interest in anything. Higher doses cause more nausea and mania so I am sticking with a low dose for now.
Hildi
PS: I've been on zoloft for eight years, prozac off and on for many years . . Paxil only a short time- terrible reaction with anxiety! Celexa severe mania and then deeper depression. Wellbutrin and effexor were both disasters, too. So you see, I've given them all a shot- in the SSRI family, I mean.
Posted by hildi on May 20, 2003, at 7:44:44
In reply to Re: p.s. there's also Strattera » hildi, posted by zeugma on May 19, 2003, at 15:57:38
> I'm taking both nortriptyline and Strattera. My dr. thinks that with 75 mg nortriptyline in my system a day, I would only need 25 mg Strattera a day to help with my ADHD- about a quarter of a normal dose. So far (day 6) it seems to be working. My mind feels transparent, not opaque (ADHD is my primary dx and my depression tends to be brought on by ADHD-related crises in my personal life and career).
>
> Nortriptyline from what I can tell is about EQUALLY potent to Strattera- there are similar effective dose ranges for the two drugs. Nortriptyline is a lot less selective, though, also blocking histaminic, cholinergic, alpha-1 adrenergic, and 5-HT 2A receptors. Some of this probably helps anxiety- e.g. histamic block causes sedation, which can help with sleep. In my experience, nortriptyline is like a stimulating drug overlaid woth a sedative, with the sedation slightly predominating, while the Strattera so far seems to be without the sedating component. That's why the Strattera and nortrip seem to be complementary and why I will continue to take both until a reason presents itself not to.
>
> So you didn't like EFfexor or Wellbutrin? I had a terrible time with WB as well- probably an allergic reaction, as I had immediate autonomic CNS side effects. WB however is a drug that seems to cause a LOT of idiosyncratic side effects and dysphoria. And it is by no means a pure NE reuptake inhibitor. Looking thru articles on WB's 'mechanisms of action' reveals convolutions unmatched by any other drug in the armaterarium. What dose Effexor were you on? Effexor at relatively low doses is more of an SRI.
>
>
I can't remember what dose of Effexor I was on it was a while ago and the experience was one I'd like to forget. It induced LSD flashblacks to me, and that was just ONE of the side effects. WB caused more anxiety, but you know, I was only on it a very short time and didn't give it a chance. Paxil, as I may have mentioned caused me so much anxiety I had a major meltdown and everything in my life fell apart. The only two SSRI's I can somewhat tolerate were prozac and zoloft, now both of those make me ill and foggy-minded, with prozac inducing next day extreme moodiness. This Lexapro I am on now feels just like the zoloft, and this is not what I want to feel like.
Hildi
Posted by worrier on May 20, 2003, at 21:53:32
In reply to nortryptline affect on anxiety, posted by hildi on May 17, 2003, at 10:11:59
> I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
>
> I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
> Hildi>I've sort of stepped into this conversation in the middle, but feel I'm in about the same boat as you and am looking for some effective alternative. I can't tolerate any of the SSRis and like you, paxil sent me straight over the edge and to the ER with the worst agitation/panic I've ever had (and I've had panic attacks for almost 20 years). It's been almost a year since the paxil disaster and I still haven't gotten back to my original "just plain old panic disorder" self. I know have a constant level of physical anxiety that I never had before the paxil.(had bad reactions to wellbutrin and prozac, but nothing like the paxil and those effects went away pretty quickly after stopping the meds.) Right now I'm getting by on xanax and stubborness, but it's very frustrating and tiring. The xanax takes the edge off, but I never really feel normal. I'm pretty gun shy about trying any new meds, but it's growing increasingly obvious I'm going to have to do something. My pdoc has suggested remeron, or maybe strattera, have you had any experience with either of those? Any suggestions would be apprecciated, as we seem to react to some meds in a very similar way. Luck to you. Worrier.
Posted by hildi on May 20, 2003, at 23:16:01
In reply to Re: nortryptline affect on anxiety, posted by worrier on May 20, 2003, at 21:53:32
> > I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
> >
> > I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
> > Hildi
>
> >I've sort of stepped into this conversation in the middle, but feel I'm in about the same boat as you and am looking for some effective alternative. I can't tolerate any of the SSRis and like you, paxil sent me straight over the edge and to the ER with the worst agitation/panic I've ever had (and I've had panic attacks for almost 20 years). It's been almost a year since the paxil disaster and I still haven't gotten back to my original "just plain old panic disorder" self. I know have a constant level of physical anxiety that I never had before the paxil.(had bad reactions to wellbutrin and prozac, but nothing like the paxil and those effects went away pretty quickly after stopping the meds.) Right now I'm getting by on xanax and stubborness, but it's very frustrating and tiring. The xanax takes the edge off, but I never really feel normal. I'm pretty gun shy about trying any new meds, but it's growing increasingly obvious I'm going to have to do something. My pdoc has suggested remeron, or maybe strattera, have you had any experience with either of those? Any suggestions would be apprecciated, as we seem to react to some meds in a very similar way. Luck to you. Worrier.You sound just like me and have gone throught the same hell with this. I completely undestand what your saying- the underlying anxiety is so much more predominant now, so much more than before the paxil. There is a constant intense agitation, or anxiety, something I cannot even put words on, that is so deep and with me constantly that nothing at all can budge this. Xanax helps some, but this intense agitation/anxiety never goes away. Clonazepam or Klonopin barely touches this. It makes me more woozy, but the agitation remains. I feel like a drunk that's all keyed up sometimes (and I don't drink).
No, my doctor says I'll hate him if he gives me Remeron because everyone gains a ton of weight on it, he says. Now Strattera was suggested by someone on this site, but wouldn't that cause MORE anxiety? It's a stimulant you know. I bet my doctor wouldn't let me try it, but I'd be curious if such a thing might actually have an opposite effect on me, since all the 'tranquilizers' are not. But then again, I am afraid. My brain and body are so wacked out at this point I feel the same as you, something must be done because I can't live like this anymore, but I am so afraid of further reactions. You know too, when I was younger and everybody was doing speed around me, every time I'd take any I'd get sick. I would vomit it up and try to sleep it away. Now, things like white crosses and black beauties that were going around then are amphetamines, but still a stimulant. I worry that I'd have a similar reaction with the strattera. It is pure NE reuptake. I considered nortript, but that is NE reuptake, amoung other things. . . so I just don't know what to do.
I don't think I can take another day of this Lexapro. I felt sick all day and emotionless.
I think the Klon makes me feel nausea, too, and I'm out of xanax, so I feel like a trapped mouse in a lab experiment gone awry.
Hildi
Posted by Jackster on May 21, 2003, at 1:56:33
In reply to Re: nortryptline affect on anxiety » Jackster, posted by hildi on May 20, 2003, at 7:30:04
> Hi. Yes, I've tried depakote and also neurotin; neither helped and actually made me feel more mania. I didn't want to give either of these meds more time or try dose adjustments because of the embarassment my mania was causing me.
> I think you're on to something with the NE induced anxiety, but I also think a little of it increases my concentration. For prozac it worked that way for a while, but then the mania I got from it was pretty intense (but totally unlike the nuerotontin or dep), then it made me more OCD and moody. Now when I take prozac, I feel good the first day and feel like a bitch the next.
> Now the lexapro I'm on now is all serotonin, and it reminds me of when I was on zoloft: sea-sick feeling and apathy. No increased concentration at all, total lack of it and no interest in anything. Higher doses cause more nausea and mania so I am sticking with a low dose for now.
> Hildi
> PS: I've been on zoloft for eight years, prozac off and on for many years . . Paxil only a short time- terrible reaction with anxiety! Celexa severe mania and then deeper depression. Wellbutrin and effexor were both disasters, too. So you see, I've given them all a shot- in the SSRI family, I mean.I know what it's like to have a med turn you into a horrible hostile cow! Both Buspar and Clomipramine had that effect on me. Sounds like you need a combo of the serotonin and NE. Have you tried taking a TCA with an SSRI? I find the TCA's are really good for motivation (that could be the dopamine though - don't know). They might counteract the apathetic feeling you get from Zoloft and Lexapro. You could try a small dose of Nortriptyline with the Lexapro. Enough to kick the apathy, but not enough to cause anxiety.
Keep us posted
Jackie
Posted by worrier on May 21, 2003, at 18:06:51
In reply to Re: nortryptline affect on anxiety » worrier, posted by hildi on May 20, 2003, at 23:16:01
> > > I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
> > >
> > > I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
> > > Hildi
> >
> > >I've sort of stepped into this conversation in the middle, but feel I'm in about the same boat as you and am looking for some effective alternative. I can't tolerate any of the SSRis and like you, paxil sent me straight over the edge and to the ER with the worst agitation/panic I've ever had (and I've had panic attacks for almost 20 years). It's been almost a year since the paxil disaster and I still haven't gotten back to my original "just plain old panic disorder" self. I know have a constant level of physical anxiety that I never had before the paxil.(had bad reactions to wellbutrin and prozac, but nothing like the paxil and those effects went away pretty quickly after stopping the meds.) Right now I'm getting by on xanax and stubborness, but it's very frustrating and tiring. The xanax takes the edge off, but I never really feel normal. I'm pretty gun shy about trying any new meds, but it's growing increasingly obvious I'm going to have to do something. My pdoc has suggested remeron, or maybe strattera, have you had any experience with either of those? Any suggestions would be apprecciated, as we seem to react to some meds in a very similar way. Luck to you. Worrier.
>
> You sound just like me and have gone throught the same hell with this. I completely undestand what your saying- the underlying anxiety is so much more predominant now, so much more than before the paxil. There is a constant intense agitation, or anxiety, something I cannot even put words on, that is so deep and with me constantly that nothing at all can budge this. Xanax helps some, but this intense agitation/anxiety never goes away. Clonazepam or Klonopin barely touches this. It makes me more woozy, but the agitation remains. I feel like a drunk that's all keyed up sometimes (and I don't drink).
> No, my doctor says I'll hate him if he gives me Remeron because everyone gains a ton of weight on it, he says. Now Strattera was suggested by someone on this site, but wouldn't that cause MORE anxiety? It's a stimulant you know. I bet my doctor wouldn't let me try it, but I'd be curious if such a thing might actually have an opposite effect on me, since all the 'tranquilizers' are not. But then again, I am afraid. My brain and body are so wacked out at this point I feel the same as you, something must be done because I can't live like this anymore, but I am so afraid of further reactions. You know too, when I was younger and everybody was doing speed around me, every time I'd take any I'd get sick. I would vomit it up and try to sleep it away. Now, things like white crosses and black beauties that were going around then are amphetamines, but still a stimulant. I worry that I'd have a similar reaction with the strattera. It is pure NE reuptake. I considered nortript, but that is NE reuptake, amoung other things. . . so I just don't know what to do.
> I don't think I can take another day of this Lexapro. I felt sick all day and emotionless.
> I think the Klon makes me feel nausea, too, and I'm out of xanax, so I feel like a trapped mouse in a lab experiment gone awry.
> Hildi>Hildi, thanks for the quick reply. I can so totally relate to everthing you say. I think I'd be willing to gain 100 pounds if remeron would actually work. I have the same concerns as you regarding strattera...seems like exactly the opposite of what I need. But like you, I almost wonder if it might not work, since the things that are suppose to be miracle cures are like poison to me. But again, like you I am terrified of more horrible side effects. The endocrinologist I've been seeing (in yet another vain attempt to find a "real" problem that's causing these symptoms) suggested that I see a different pdoc who is in her opinion a virtual god at findinng the right meds for whatever is screwing up the works...I really don't think its worth the efffort...talk about feeling like the lab rat caught in the experiment gone bad! Can't get an appt with my pdoc until June 10, so I guess I'll just muddle along until then and see if I can work up the courage to try something new. Let me know if you hit on something that helps..I'll do the same. Oh, I had some muscle relaxers left over from a back problem (Robaxin) and just for the hell of it took one the other night. I think it actually helped a bit...relaxed me a bit more than just the xanax...I think alot of my "anxiety" if that's even what it is takes on a very physical form and every muscle in my body is absolutely tense all the time. Will discuss this with my pdoc too, as I'm not sure if its ok to take it and benzos together. Anyway, it might be something for you to think about. By the way, are your symptoms primarily physical or do you have lots of worry/anxiety type thinking? I don't seem to have the mental stuff, except as it relates to the agitation/anxiety. In other words all I seem to worry about is how weird and wired I feel. Is this the case with you too? Just curious. Good luck and hang in there, we're boung to find a way out of this somehow. Worrier.
Posted by hildi on May 21, 2003, at 20:59:30
In reply to Re: nortryptline affect on anxiety, posted by worrier on May 21, 2003, at 18:06:51
> > > > I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
> > > >
> > > > I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
> > > > Hildi
> > >
> > > >I've sort of stepped into this conversation in the middle, but feel I'm in about the same boat as you and am looking for some effective alternative. I can't tolerate any of the SSRis and like you, paxil sent me straight over the edge and to the ER with the worst agitation/panic I've ever had (and I've had panic attacks for almost 20 years). It's been almost a year since the paxil disaster and I still haven't gotten back to my original "just plain old panic disorder" self. I know have a constant level of physical anxiety that I never had before the paxil.(had bad reactions to wellbutrin and prozac, but nothing like the paxil and those effects went away pretty quickly after stopping the meds.) Right now I'm getting by on xanax and stubborness, but it's very frustrating and tiring. The xanax takes the edge off, but I never really feel normal. I'm pretty gun shy about trying any new meds, but it's growing increasingly obvious I'm going to have to do something. My pdoc has suggested remeron, or maybe strattera, have you had any experience with either of those? Any suggestions would be apprecciated, as we seem to react to some meds in a very similar way. Luck to you. Worrier.
> >
> > You sound just like me and have gone throught the same hell with this. I completely undestand what your saying- the underlying anxiety is so much more predominant now, so much more than before the paxil. There is a constant intense agitation, or anxiety, something I cannot even put words on, that is so deep and with me constantly that nothing at all can budge this. Xanax helps some, but this intense agitation/anxiety never goes away. Clonazepam or Klonopin barely touches this. It makes me more woozy, but the agitation remains. I feel like a drunk that's all keyed up sometimes (and I don't drink).
> > No, my doctor says I'll hate him if he gives me Remeron because everyone gains a ton of weight on it, he says. Now Strattera was suggested by someone on this site, but wouldn't that cause MORE anxiety? It's a stimulant you know. I bet my doctor wouldn't let me try it, but I'd be curious if such a thing might actually have an opposite effect on me, since all the 'tranquilizers' are not. But then again, I am afraid. My brain and body are so wacked out at this point I feel the same as you, something must be done because I can't live like this anymore, but I am so afraid of further reactions. You know too, when I was younger and everybody was doing speed around me, every time I'd take any I'd get sick. I would vomit it up and try to sleep it away. Now, things like white crosses and black beauties that were going around then are amphetamines, but still a stimulant. I worry that I'd have a similar reaction with the strattera. It is pure NE reuptake. I considered nortript, but that is NE reuptake, amoung other things. . . so I just don't know what to do.
> > I don't think I can take another day of this Lexapro. I felt sick all day and emotionless.
> > I think the Klon makes me feel nausea, too, and I'm out of xanax, so I feel like a trapped mouse in a lab experiment gone awry.
> > Hildi
>
> >Hildi, thanks for the quick reply. I can so totally relate to everthing you say. I think I'd be willing to gain 100 pounds if remeron would actually work. I have the same concerns as you regarding strattera...seems like exactly the opposite of what I need. But like you, I almost wonder if it might not work, since the things that are suppose to be miracle cures are like poison to me. But again, like you I am terrified of more horrible side effects. The endocrinologist I've been seeing (in yet another vain attempt to find a "real" problem that's causing these symptoms) suggested that I see a different pdoc who is in her opinion a virtual god at findinng the right meds for whatever is screwing up the works...I really don't think its worth the efffort...talk about feeling like the lab rat caught in the experiment gone bad! Can't get an appt with my pdoc until June 10, so I guess I'll just muddle along until then and see if I can work up the courage to try something new. Let me know if you hit on something that helps..I'll do the same. Oh, I had some muscle relaxers left over from a back problem (Robaxin) and just for the hell of it took one the other night. I think it actually helped a bit...relaxed me a bit more than just the xanax...I think alot of my "anxiety" if that's even what it is takes on a very physical form and every muscle in my body is absolutely tense all the time. Will discuss this with my pdoc too, as I'm not sure if its ok to take it and benzos together. Anyway, it might be something for you to think about. By the way, are your symptoms primarily physical or do you have lots of worry/anxiety type thinking? I don't seem to have the mental stuff, except as it relates to the agitation/anxiety. In other words all I seem to worry about is how weird and wired I feel. Is this the case with you too? Just curious. Good luck and hang in there, we're boung to find a way out of this somehow. Worrier.YES! The way I feel is just what you summed up in the 2 last sentences: it is not really mental anxiety-except for the worry about how wierd and wired I feel! For the most part this is purely physical.
Robaxin helped you some? I have never heard of it- it is a muscle relaxer? Hmmm. I don't have anything like that around, but I'd give it a try if I did. From time to time I find some anxiety relief from benedryl (antihistimine)- but then it makes me tired too; but for a couple days I was feeling a little better by taking some benedryl along with my klonopin. It isn't enough to count on though. . .
Why don't you try that 'new pdoc'that endocriniologist recommended? I would be interested in a new perspective- maybe he/she knows something that can help us. The June 10th appointment is with your 'old pdoc'? I am curious about his recommendation for Strattera- who knows, maybe something like this is worth considering, since we both respond so negatively or oppositely to the way meds are suppose to work! But I don't want to be the one to try it- I'm too chicken! You try it first!
Let me know what you decide to do and what you find out, and I will do the same. Maybe between the two of us we can come up with some answers.
Hang in there and keep me posted.
Hildi
Posted by worrier on May 22, 2003, at 20:37:11
In reply to Re: nortryptline affect on anxiety » worrier, posted by hildi on May 21, 2003, at 20:59:30
> > > > > I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
> > > > >
> > > > > I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
> > > > > Hildi
> > > >
> > > > >I've sort of stepped into this conversation in the middle, but feel I'm in about the same boat as you and am looking for some effective alternative. I can't tolerate any of the SSRis and like you, paxil sent me straight over the edge and to the ER with the worst agitation/panic I've ever had (and I've had panic attacks for almost 20 years). It's been almost a year since the paxil disaster and I still haven't gotten back to my original "just plain old panic disorder" self. I know have a constant level of physical anxiety that I never had before the paxil.(had bad reactions to wellbutrin and prozac, but nothing like the paxil and those effects went away pretty quickly after stopping the meds.) Right now I'm getting by on xanax and stubborness, but it's very frustrating and tiring. The xanax takes the edge off, but I never really feel normal. I'm pretty gun shy about trying any new meds, but it's growing increasingly obvious I'm going to have to do something. My pdoc has suggested remeron, or maybe strattera, have you had any experience with either of those? Any suggestions would be apprecciated, as we seem to react to some meds in a very similar way. Luck to you. Worrier.
> > >
> > > You sound just like me and have gone throught the same hell with this. I completely undestand what your saying- the underlying anxiety is so much more predominant now, so much more than before the paxil. There is a constant intense agitation, or anxiety, something I cannot even put words on, that is so deep and with me constantly that nothing at all can budge this. Xanax helps some, but this intense agitation/anxiety never goes away. Clonazepam or Klonopin barely touches this. It makes me more woozy, but the agitation remains. I feel like a drunk that's all keyed up sometimes (and I don't drink).
> > > No, my doctor says I'll hate him if he gives me Remeron because everyone gains a ton of weight on it, he says. Now Strattera was suggested by someone on this site, but wouldn't that cause MORE anxiety? It's a stimulant you know. I bet my doctor wouldn't let me try it, but I'd be curious if such a thing might actually have an opposite effect on me, since all the 'tranquilizers' are not. But then again, I am afraid. My brain and body are so wacked out at this point I feel the same as you, something must be done because I can't live like this anymore, but I am so afraid of further reactions. You know too, when I was younger and everybody was doing speed around me, every time I'd take any I'd get sick. I would vomit it up and try to sleep it away. Now, things like white crosses and black beauties that were going around then are amphetamines, but still a stimulant. I worry that I'd have a similar reaction with the strattera. It is pure NE reuptake. I considered nortript, but that is NE reuptake, amoung other things. . . so I just don't know what to do.
> > > I don't think I can take another day of this Lexapro. I felt sick all day and emotionless.
> > > I think the Klon makes me feel nausea, too, and I'm out of xanax, so I feel like a trapped mouse in a lab experiment gone awry.
> > > Hildi
> >
> > >Hildi, thanks for the quick reply. I can so totally relate to everthing you say. I think I'd be willing to gain 100 pounds if remeron would actually work. I have the same concerns as you regarding strattera...seems like exactly the opposite of what I need. But like you, I almost wonder if it might not work, since the things that are suppose to be miracle cures are like poison to me. But again, like you I am terrified of more horrible side effects. The endocrinologist I've been seeing (in yet another vain attempt to find a "real" problem that's causing these symptoms) suggested that I see a different pdoc who is in her opinion a virtual god at findinng the right meds for whatever is screwing up the works...I really don't think its worth the efffort...talk about feeling like the lab rat caught in the experiment gone bad! Can't get an appt with my pdoc until June 10, so I guess I'll just muddle along until then and see if I can work up the courage to try something new. Let me know if you hit on something that helps..I'll do the same. Oh, I had some muscle relaxers left over from a back problem (Robaxin) and just for the hell of it took one the other night. I think it actually helped a bit...relaxed me a bit more than just the xanax...I think alot of my "anxiety" if that's even what it is takes on a very physical form and every muscle in my body is absolutely tense all the time. Will discuss this with my pdoc too, as I'm not sure if its ok to take it and benzos together. Anyway, it might be something for you to think about. By the way, are your symptoms primarily physical or do you have lots of worry/anxiety type thinking? I don't seem to have the mental stuff, except as it relates to the agitation/anxiety. In other words all I seem to worry about is how weird and wired I feel. Is this the case with you too? Just curious. Good luck and hang in there, we're boung to find a way out of this somehow. Worrier.
>
> YES! The way I feel is just what you summed up in the 2 last sentences: it is not really mental anxiety-except for the worry about how wierd and wired I feel! For the most part this is purely physical.
> Robaxin helped you some? I have never heard of it- it is a muscle relaxer? Hmmm. I don't have anything like that around, but I'd give it a try if I did. From time to time I find some anxiety relief from benedryl (antihistimine)- but then it makes me tired too; but for a couple days I was feeling a little better by taking some benedryl along with my klonopin. It isn't enough to count on though. . .
> Why don't you try that 'new pdoc'that endocriniologist recommended? I would be interested in a new perspective- maybe he/she knows something that can help us. The June 10th appointment is with your 'old pdoc'? I am curious about his recommendation for Strattera- who knows, maybe something like this is worth considering, since we both respond so negatively or oppositely to the way meds are suppose to work! But I don't want to be the one to try it- I'm too chicken! You try it first!
> Let me know what you decide to do and what you find out, and I will do the same. Maybe between the two of us we can come up with some answers.
> Hang in there and keep me posted.
> Hildi>Hey Hildi, actually I was hoping you'd try it first...I'm pretty chicken myself. However, I did go ahead and make an appt. with the new pdoc, but can't get in until July....so I'm going to the old one June 10 and will discuss the strattera thing and maybe go ahead and give it a try (as long as he'll let me keep the xanax, just in case). Guess we'll decide between that and remeron, he did say it tended to be more sedating. I don't want to be sedated, I just want to be relaxed! About the Robaxin, it is a muscle relaxer, you might ask your doc about something along those lines since you, like me have mostly physical symptoms. Benadryl does help me a bit too, but not much, and probably not worth the dry mouth, spacey feeling that comes with it if you take enough to notice. It's really comforting in an odd way to know someone else out there knows what I'm talking about. I hate that you feel this way too, but if nothing else misery loves company! Best to you and keep in touch, I'll let you know how things go...this week has been tough, but maybe just making up my mind to try something new may help renew hope. Worrier.
Posted by Caleb462 on May 22, 2003, at 22:40:38
In reply to Re: nortryptline affect on anxiety » worrier, posted by hildi on May 20, 2003, at 23:16:01
> > > I'm wanting to try another route than SSRI's for my anxiety and depression- I have read some good posts about nortryptline, but would that med cause even more anxeity? Also, I have read that the TCA's are bad for those who have bipolar tendencies. Does anyone have any comments or experience with this?
> > >
> > > I'm interested- never tried a TCA. I've always been on SSRI's and they all make me feel lousy in one way or another.
> > > Hildi
> >
> > >I've sort of stepped into this conversation in the middle, but feel I'm in about the same boat as you and am looking for some effective alternative. I can't tolerate any of the SSRis and like you, paxil sent me straight over the edge and to the ER with the worst agitation/panic I've ever had (and I've had panic attacks for almost 20 years). It's been almost a year since the paxil disaster and I still haven't gotten back to my original "just plain old panic disorder" self. I know have a constant level of physical anxiety that I never had before the paxil.(had bad reactions to wellbutrin and prozac, but nothing like the paxil and those effects went away pretty quickly after stopping the meds.) Right now I'm getting by on xanax and stubborness, but it's very frustrating and tiring. The xanax takes the edge off, but I never really feel normal. I'm pretty gun shy about trying any new meds, but it's growing increasingly obvious I'm going to have to do something. My pdoc has suggested remeron, or maybe strattera, have you had any experience with either of those? Any suggestions would be apprecciated, as we seem to react to some meds in a very similar way. Luck to you. Worrier.
>
> You sound just like me and have gone throught the same hell with this. I completely undestand what your saying- the underlying anxiety is so much more predominant now, so much more than before the paxil. There is a constant intense agitation, or anxiety, something I cannot even put words on, that is so deep and with me constantly that nothing at all can budge this. Xanax helps some, but this intense agitation/anxiety never goes away. Clonazepam or Klonopin barely touches this. It makes me more woozy, but the agitation remains. I feel like a drunk that's all keyed up sometimes (and I don't drink).
> No, my doctor says I'll hate him if he gives me Remeron because everyone gains a ton of weight on it, he says. Now Strattera was suggested by someone on this site, but wouldn't that cause MORE anxiety? It's a stimulant you know. I bet my doctor wouldn't let me try it, but I'd be curious if such a thing might actually have an opposite effect on me, since all the 'tranquilizers' are not. But then again, I am afraid. My brain and body are so wacked out at this point I feel the same as you, something must be done because I can't live like this anymore, but I am so afraid of further reactions. You know too, when I was younger and everybody was doing speed around me, every time I'd take any I'd get sick. I would vomit it up and try to sleep it away. Now, things like white crosses and black beauties that were going around then are amphetamines, but still a stimulant. I worry that I'd have a similar reaction with the strattera. It is pure NE reuptake. I considered nortript, but that is NE reuptake, amoung other things. . . so I just don't know what to do.
> I don't think I can take another day of this Lexapro. I felt sick all day and emotionless.
> I think the Klon makes me feel nausea, too, and I'm out of xanax, so I feel like a trapped mouse in a lab experiment gone awry.
> Hildi
Actually, NE reuptake is considered GOOD for anxiety. Initially, strattera (or any other NE uptake inhibitor) might cause some degree of increased anxiety, but the end result will be a down-regulation of adrenergic receptors - and thus an anti-anxiety effect. This is the reason Effexor (a mixed serotonin/norepinephrine reuptake inhibitor) is touted so strongly for co-morbid anxiety and depression.
This is the end of the thread.
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