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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by JESSsMom on June 6, 2003, at 9:00:18
Hi All,
This is what I take daily--sounds overwhelming, I know, but I am often treatment resistant to meds, suffer greatly, and am debilitated by my GAD, comorbid depression, obsessional thinking, agoraphobia, and insomnia:
--112.5 mg Effexor XR for anxiety and depression,
--6 mg Gabitril (slowly titrating up)
--5 mg Xanax as needed
--50-100 mg Luvox intermittently for intrusive obsessional thinking and depression (I know "intermittently" is not beneficial to most but it helps me, excluding the agitation)
--30 mg Dalmane for the terrible insomnia caused by the GAD, depression, and of course the Effexor XR and the Luvox.The Effexor XR plays with my body temperature--I am so hot when everyone else is comfortable or even chilly. I used to sweat terribly on it until I found a remedy for that, thank God.
When I try to increase the Gabitril it knocks my socks off for the entire next day: flat affect, bad short term memory loss, and debilitating somnolence. But my pdoc, of course, wants me to increase the Gabitril so that I can eventually lower my benzo intake.
Also, the 30 mg of Dalmane causes extreme somnolence the next day. It's a hypnotic with a long half life. I am going to try to break a capsule in half tonight and only take 15 mg, but how on earth do you split a capsule without losing all the things inside? It's not like a tablet that I can just cut in half.
Any comments or advice are greatly appreciated.God Bless,
JM
Posted by JESSsMom on June 8, 2003, at 15:51:53
In reply to Severe GAD/Depression, posted by JESSsMom on June 6, 2003, at 9:00:18
Posted by Ritch on June 9, 2003, at 9:47:37
In reply to Severe GAD/Depression, posted by JESSsMom on June 6, 2003, at 9:00:18
> Hi All,
>
> This is what I take daily--sounds overwhelming, I know, but I am often treatment resistant to meds, suffer greatly, and am debilitated by my GAD, comorbid depression, obsessional thinking, agoraphobia, and insomnia:
>
> --112.5 mg Effexor XR for anxiety and depression,
> --6 mg Gabitril (slowly titrating up)
> --5 mg Xanax as needed
> --50-100 mg Luvox intermittently for intrusive obsessional thinking and depression (I know "intermittently" is not beneficial to most but it helps me, excluding the agitation)
> --30 mg Dalmane for the terrible insomnia caused by the GAD, depression, and of course the Effexor XR and the Luvox.
>
> The Effexor XR plays with my body temperature--I am so hot when everyone else is comfortable or even chilly. I used to sweat terribly on it until I found a remedy for that, thank God.
> When I try to increase the Gabitril it knocks my socks off for the entire next day: flat affect, bad short term memory loss, and debilitating somnolence. But my pdoc, of course, wants me to increase the Gabitril so that I can eventually lower my benzo intake.
> Also, the 30 mg of Dalmane causes extreme somnolence the next day. It's a hypnotic with a long half life. I am going to try to break a capsule in half tonight and only take 15 mg, but how on earth do you split a capsule without losing all the things inside? It's not like a tablet that I can just cut in half.
> Any comments or advice are greatly appreciated.
>
> God Bless,
> JM
>I've been on all of those meds (at different times and not all together). Dalmane was the first sleep med I was prescribed. That stuff accumulates in your body and you wind up being zoned all day. You might ask about temazepam instead. You said your primary symptoms are GAD/agoraphobia/depression/insomnia? Have you ever been on tricyclic antidepressants? Just a thought--but you *might* be able to replace most or all of your meds with amitriptyline (Elavil) at bedtime. You might ask your doc about that-if you have'nt tried it before.
Posted by JESSsMom on June 10, 2003, at 13:00:19
In reply to Re: Severe GAD/Depression » JESSsMom, posted by Ritch on June 9, 2003, at 9:47:37
> > Hi All,
> >
> > This is what I take daily--sounds overwhelming, I know, but I am often treatment resistant to meds, suffer greatly, and am debilitated by my GAD, comorbid depression, obsessional thinking, agoraphobia, and insomnia:
> >
> > --112.5 mg Effexor XR for anxiety and depression,
> > --6 mg Gabitril (slowly titrating up)
> > --5 mg Xanax as needed
> > --50-100 mg Luvox intermittently for intrusive obsessional thinking and depression (I know "intermittently" is not beneficial to most but it helps me, excluding the agitation)
> > --30 mg Dalmane for the terrible insomnia caused by the GAD, depression, and of course the Effexor XR and the Luvox.
> >
> > The Effexor XR plays with my body temperature--I am so hot when everyone else is comfortable or even chilly. I used to sweat terribly on it until I found a remedy for that, thank God.
> > When I try to increase the Gabitril it knocks my socks off for the entire next day: flat affect, bad short term memory loss, and debilitating somnolence. But my pdoc, of course, wants me to increase the Gabitril so that I can eventually lower my benzo intake.
> > Also, the 30 mg of Dalmane causes extreme somnolence the next day. It's a hypnotic with a long half life. I am going to try to break a capsule in half tonight and only take 15 mg, but how on earth do you split a capsule without losing all the things inside? It's not like a tablet that I can just cut in half.
> > Any comments or advice are greatly appreciated.
> >
> > God Bless,
> > JM
> >
>
> I've been on all of those meds (at different times and not all together). Dalmane was the first sleep med I was prescribed. That stuff accumulates in your body and you wind up being zoned all day. You might ask about temazepam instead. You said your primary symptoms are GAD/agoraphobia/depression/insomnia? Have you ever been on tricyclic antidepressants? Just a thought--but you *might* be able to replace most or all of your meds with amitriptyline (Elavil) at bedtime. You might ask your doc about that-if you have'nt tried it before.Ritch, thanks so much for your reply. Had a pdoc appointment yesterday--no more Gabitril. Also, used Restoril for a few months until it stopped working (60mg. and I was up til 4am when I finally would break down and take an extra Xanax). Pdoc says all benzo sleeping aids eventually poop out. As for Elavil--yes, been on it (been on everything, it seems over the last 13 years) and gained weight like crazy.
Yesterday pdoc suggested continuing with cutting the Dalmane in half and added a small dose of Zoloft for the complete lack of energy and motivation. Can't win--either scared to death all the time or no motivation. Sucks.
Thanks again, Ritch.
JM
Posted by Ritch on June 10, 2003, at 22:42:53
In reply to Re: Severe GAD/Depression, posted by JESSsMom on June 10, 2003, at 13:00:19
> > > Hi All,
> > >
> > > This is what I take daily--sounds overwhelming, I know, but I am often treatment resistant to meds, suffer greatly, and am debilitated by my GAD, comorbid depression, obsessional thinking, agoraphobia, and insomnia:
> > >
> > > --112.5 mg Effexor XR for anxiety and depression,
> > > --6 mg Gabitril (slowly titrating up)
> > > --5 mg Xanax as needed
> > > --50-100 mg Luvox intermittently for intrusive obsessional thinking and depression (I know "intermittently" is not beneficial to most but it helps me, excluding the agitation)
> > > --30 mg Dalmane for the terrible insomnia caused by the GAD, depression, and of course the Effexor XR and the Luvox.
> > >
> > > The Effexor XR plays with my body temperature--I am so hot when everyone else is comfortable or even chilly. I used to sweat terribly on it until I found a remedy for that, thank God.
> > > When I try to increase the Gabitril it knocks my socks off for the entire next day: flat affect, bad short term memory loss, and debilitating somnolence. But my pdoc, of course, wants me to increase the Gabitril so that I can eventually lower my benzo intake.
> > > Also, the 30 mg of Dalmane causes extreme somnolence the next day. It's a hypnotic with a long half life. I am going to try to break a capsule in half tonight and only take 15 mg, but how on earth do you split a capsule without losing all the things inside? It's not like a tablet that I can just cut in half.
> > > Any comments or advice are greatly appreciated.
> > >
> > > God Bless,
> > > JM
> > >
> >
> > I've been on all of those meds (at different times and not all together). Dalmane was the first sleep med I was prescribed. That stuff accumulates in your body and you wind up being zoned all day. You might ask about temazepam instead. You said your primary symptoms are GAD/agoraphobia/depression/insomnia? Have you ever been on tricyclic antidepressants? Just a thought--but you *might* be able to replace most or all of your meds with amitriptyline (Elavil) at bedtime. You might ask your doc about that-if you have'nt tried it before.
>
> Ritch, thanks so much for your reply. Had a pdoc appointment yesterday--no more Gabitril. Also, used Restoril for a few months until it stopped working (60mg. and I was up til 4am when I finally would break down and take an extra Xanax). Pdoc says all benzo sleeping aids eventually poop out. As for Elavil--yes, been on it (been on everything, it seems over the last 13 years) and gained weight like crazy.
> Yesterday pdoc suggested continuing with cutting the Dalmane in half and added a small dose of Zoloft for the complete lack of energy and motivation. Can't win--either scared to death all the time or no motivation. Sucks.
> Thanks again, Ritch.
> JMHave you tried nortriptyline (Pamelor)??
Posted by JESSsMom on June 11, 2003, at 18:20:28
In reply to Re: Severe GAD/Depression » JESSsMom, posted by Ritch on June 10, 2003, at 22:42:53
No, haven't tried that one. Gonna do a little research right now on it. Thanks once again.
JM
Posted by Ritch on June 11, 2003, at 21:41:28
In reply to Re: Severe GAD/Depression » Ritch, posted by JESSsMom on June 11, 2003, at 18:20:28
> No, haven't tried that one. Gonna do a little research right now on it. Thanks once again.
> JM
Just an FYI, it(nortriptyline) is the primary metabolite in the body of amitriptyline (Elavil). It is much less sedating, produces less dry mouth and constipation than Elavil. It's the only TCA (of several) that I would ever try again.
This is the end of the thread.
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