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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by francesco on February 10, 2004, at 16:12:54
Is there someone who manages to do something with a 'monotherapy' with benzos ? It seems that they are the only thing that I can tolerate and that they improve all my syntoms (also lack of concentration and urological problems !) with no noticeable side-effects. I know about the risk of addiction and so on, but in the last period I'm having horrible experiences with ADs, can't stand them for more than a week or even less. I quit Parmodalin (Parnate+Stelazine) more than a week ago and I still felt very very confused and impaired. I wrote an e-mail to my psychiatrist and he said to take xaxax because benzos can help with 'confusion induced by meds'. I took a xanax a couple of hours ago and I feel reborn. I have been able to feel pleasure for the first time in the last two weeks and my brain is working again. Benzos seem to be no more indicated for psychiatric disturbs but I'm wondering how much worse can be of SSRIs. What follows is a list of my reaction to antidepressants
Paxil - rageous mania, horrible withdrawal
Celexa - slept for two months
Prozac - first time hypomaniac with some psychotic features, second time suicidal
Wellbutrin - irritable (to say an euphemism) and extremely forgetful
Anafranil - I took it for years, helped a lot with concentration issues, but made me sociophobic and alcoholic in social situation
Remeron - derealization feelings, like a zombie
(I skip the other meds not to bore you)I must stress that the only syntoms I can complain about when I'm not on meds are adhd-like, which are not life-threatening. When I was on meds I experienced major depression,suicidal thoughts, induced mania, irritability, severe anedhonia and the whole range of the psychiatric disorders ... disorders that I don't have when I'm not on meds !!!
Could my drugs be my problems ?
Posted by KellyD on February 10, 2004, at 16:51:22
In reply to only benzos ?, posted by francesco on February 10, 2004, at 16:12:54
> Is there someone who manages to do something with a 'monotherapy' with benzos ?
Me.... and the something I do is lead a pretty good exsistence.
I do use suppliments but in terms of RX... only a benzo.
Posted by Chairman_MAO on February 10, 2004, at 17:15:59
In reply to only benzos ?, posted by francesco on February 10, 2004, at 16:12:54
Glad to see you're feeling better. Sure, you can take only benzos. But their use long-term carries some risks that will creep up on you over time, namely depression and memory impairment. Xanax has some subtle antidepressant qualities, though, as does adinazolam, which I would suggest you try if it is available in your country. For what it's worth, I think clonazepam is the best benzo for long-term use: really long half life, excellent anti-OCD action that is not found in any other benzo. After being slightly familiarized with your issues, I'd recommend starting with _low_ dose selegiline to augment a benzo for your ADHD symptoms. We're talking like 1.25mg/day or 1mg/day of the liquid, titrating up only as needed. It has MANY antioxidant, neuroprotective, and nootropic properties that accrue with long-term administration, totally unrelated to MAO-B inhibition. Excellent for mild focusing problems.
I'd use it again if my pdoc weren't so conventional. Today I started 150mg Wellbutrin XL. I must say, in the past when I tried it it made me EXTREMELY agitated, skittish and irritable. However, I am also taking 900mg/day of Trileptal and am pleased to say that its preventing the agitation thusfar. I will only be able to say whether it's working out for sure at this dose until 10 days from now, but so far so good.
But I've gotta say, Wellbutrin has such a lame buzz compared to even selegiline. If I were able to get a benzo prescribed, I'd probably still be on 15mg/day of selegiline and the benzo--that's it.
P.S. You've got be on benzos for at LEAST a month before you see whether they help; there is a 'honeymoon' period after which they don't seem quite as amazing. Stay on them and you'll see what I'm talking about. Also, be aware that if you want to get off of them for any reason, it very well might be disabling, even with a slow taper.
Posted by Sad Panda on February 12, 2004, at 8:12:41
In reply to only benzos ?, posted by francesco on February 10, 2004, at 16:12:54
> Is there someone who manages to do something with a 'monotherapy' with benzos ? It seems that they are the only thing that I can tolerate and that they improve all my syntoms (also lack of concentration and urological problems !) with no noticeable side-effects. I know about the risk of addiction and so on, but in the last period I'm having horrible experiences with ADs, can't stand them for more than a week or even less. I quit Parmodalin (Parnate+Stelazine) more than a week ago and I still felt very very confused and impaired. I wrote an e-mail to my psychiatrist and he said to take xaxax because benzos can help with 'confusion induced by meds'. I took a xanax a couple of hours ago and I feel reborn. I have been able to feel pleasure for the first time in the last two weeks and my brain is working again. Benzos seem to be no more indicated for psychiatric disturbs but I'm wondering how much worse can be of SSRIs. What follows is a list of my reaction to antidepressants
>
> Paxil - rageous mania, horrible withdrawal
> Celexa - slept for two months
> Prozac - first time hypomaniac with some psychotic features, second time suicidal
> Wellbutrin - irritable (to say an euphemism) and extremely forgetful
> Anafranil - I took it for years, helped a lot with concentration issues, but made me sociophobic and alcoholic in social situation
> Remeron - derealization feelings, like a zombie
> (I skip the other meds not to bore you)
>
> I must stress that the only syntoms I can complain about when I'm not on meds are adhd-like, which are not life-threatening. When I was on meds I experienced major depression,suicidal thoughts, induced mania, irritability, severe anedhonia and the whole range of the psychiatric disorders ... disorders that I don't have when I'm not on meds !!!
>
> Could my drugs be my problems ?
>Since you had some success with Clomipramine(Anafranil) & mannaged to get a degree while on it have you considered some of the secondary TCA's with less side effects like Desipramine & Nortriptyline? What can you actually get in Italy?
Cheers,
Panda.
Posted by francesco on February 13, 2004, at 13:49:06
In reply to Re: only benzos ? » francesco, posted by Sad Panda on February 12, 2004, at 8:12:41
> Since you had some success with Clomipramine(Anafranil) & mannaged to get a degree while on it have you considered some of the secondary TCA's with less side effects like Desipramine & Nortriptyline? What can you actually get in Italy?
>
> Cheers,
> Panda.ramine(Anafranil) & mannaged to get a degree while on it have you considered some of the secondary TCA's with less side effects like Desipramine & Nortriptyline? What can you actually get in Italy?
Hi Panda, Desipramine and Nortriptyline are worth of a trial ... actually I tried Desipramine but just for a few days at a very low dosage ... it wasn't bad, I have to say, but I suspect that Clomipramine helped more with my concentration issues. Anyway, I was quite happy while on Desipramine, having positive feelings toward others, but in a quite dumb way. I have had also problems with erection but in that period I was taking also meds for prostatis that I suspect could have contributed to the problem. Then I started Remeron and my state precipitated, spaciness, sleepiness and confusion were making me depressed ... So I quit Remeron after five or six days and went back to desipramine alone. I can't remember at that moment which was the problem that convinced me to quit also desipramine (maybe sexual dysfunction). In that period I had been prescribed also a mood stabilizer (Trileptal) which I stupidly 'forgot' to take. I can remember a night when I was very very impaired by Remeron and I took Trileptal to see if it could help. It helped within an hour but I'm a sucker, I refused to take the mood stabilizer on a regular basis because I didn't accept my psychiatrist's diagnosis which is more focused on mood problems than on attentional problems. Sorry, I rambled a bit, I'm taking xanax and I think it's contributing to my 'extroverted writing'. I wrote some embarassing mails in this period, I have read somewhere that xanax can do this to borderline personalities. There seems to be a great overlap between BP II, adhd, and bpd and I think now that I have some BP traits (never self mutilated anyway or things like that).
To answer your question ... I just don't know what I'll do, first of all I want to recover from the withdrawal from the damned Parmodalin. I'm still confused if I don't take xanax, I have troubles with coordination and muscle strenght, I pray God this has nothing to do with the trifluoperazine which was in the compound and that it's only in my head. When I'll be back, hoping I'll be back, I would be quite happy and I could reconsider taking meds ... Clomipramine is an option, Effexor is another, Desipramine and Imipramine why not ? But I have to take the mood stabilizer if I want to take antidepressants or I will go mad for sure. In Italy I can get all the SSRIs and all the TCAs, not MAOIs and not RIMAs, maybe Nardil but it could be quite expensive because I have to buy it in the Vatican Pharmacy, which is ... abroad, even if in Rome.
I'm a bit worry for the this withdrawal, I have played too much with my brain in the last period. If I decide to come back to meds I want to take them in the right way, but I'm scared anyway because I had horrible experiences with meds in the last 14 months or so. I have read extracts of books like "Prozac, Panacea or Pandora" and I think it's not just crap, I've been there ... I drank a lot more when I was on Anafranil and I was hostile and shy, I became manic on Paxil, and without meds I'm not that horrible, just lacking organization and self control in minor issues. So, my question is yet: to med or not to med ?
Sorry for this very long reply, I really appreciate your concern and suggestions : )
Posted by francesco on February 14, 2004, at 7:38:50
In reply to Re: only benzos ? » francesco, posted by Chairman_MAO on February 10, 2004, at 17:15:59
Hi Chairman,
Thanks for answering and suggestions. I wanted to ask you if you know how much time it takes to Parnate to get out of my system. I took Parnate+Trifluoperazine for just six days. In that period I added also 300mg lithium but I quit it after two-tree days. It's about ten days since I quit all but I'm still confused. My cognition and memory are impaired even if they improve a litte with xanax. I don't know this is a great strategy to withdraw from the stuff since as you've pointed out benzo can cause in themselves memory problems. I just took 1mg of trifluoperazine for six days. Could it be the culprit ? I just don't know what to think, I had a similar reaction when I quit Wellbutrin last August and I had been taking it only for ten days. I think I made a mess with my brain, taking drugs and quitting them after few days. I'm not depressed at the moment but I'm light headed and a bit demential. Any idea of what's going on ? Thanks
Posted by Chairman_MAO on February 14, 2004, at 8:35:16
In reply to Re: only benzos ?, posted by francesco on February 14, 2004, at 7:38:50
I'm not an MD or PhD., so I can't give you any opinion on what is causing your symtpoms because, as you said, you've been on so many drugs. I doubt very much the Stelazine at that dosage for that time did anything. MAO activity is supposed to recover after Parnte within 3-5 days, AFAIK, so I don't think that could be the culprit, either--at least not alone. Your hypothesis is probably correct, but I'd ask you doctor about this. I know that my doctor, after I tried and failed 3 antidepressants over a 6-week period, made me stay off antidepressants for a week, but stay on my mood stabilizer, to allow my brain to sort things out. Otherwise, he said, he'd have no idea what he was treating.
The "downstream" effects of benzodiazepines are also mostly beyond the scope of my knowledge, but I'd imagine that, given their anticonvulsant prowess, they correct abberent brain activity enough to be helpful in your situation. My advice would be to work out a mood stabilizer during this time and then continue looking for the right medication after you've sorted your current problem out; you don't want to create a benzo dependency because of this!
For what it's worth, my experience with Trileptal (oxcarbazepine) has been remarkable. At 600mg/day, it helped a litte, but at 900mg/day, taking 150mg of Wellbutrin has hardly been agitating at all, and on day 5 of the Wellbutrin, I can barely feel its effects at all. Before Trileptal (even on diazepam), I felt quite disorganized mentally and a dysphoric buzz on 150mg Wellbutrin. My psychologist told me a lot of her adult ADD patients respond well to mood-stabilizers.
Posted by francesco on February 15, 2004, at 8:02:00
In reply to Re: only benzos ? » francesco, posted by Chairman_MAO on February 14, 2004, at 8:35:16
> For what it's worth, my experience with Trileptal (oxcarbazepine) has been remarkable. At 600mg/day, it helped a litte, but at 900mg/day, taking 150mg of Wellbutrin has hardly been agitating at all, and on day 5 of the Wellbutrin, I can barely feel its effects at all. Before Trileptal (even on diazepam), I felt quite disorganized mentally and a dysphoric buzz on 150mg Wellbutrin. My psychologist told me a lot of her adult ADD patients respond well to mood-stabilizers.
Thanks for the support, I tried Trileptal alone for a couple of weeks at 300mg. It was not bad, it helped also with concentration issues but I'm concerned about the flattening of emotions that many reports on the mood stabilizers and that, unfortunately, affected also me. Did you experience something like that ? My psychiatrist wants me on a mood stabilizer but I'm not so sure I want to be on them. I don't like to be on xanax, I'm scared about withdrawal and I fear that what I have experienced recently *can* be a benzo withdrawal (instead of lithium or parnate withdrawal). I didn't realize I had been taking oxazepam in the period I was making experiments with meds, never thought about benzos as something potentially addictive, even if, of course, I knew. My psychiatrist didn't precribe me benzos but he said I could take it, and that was probably a mistake, because I need straight instructions because of my adhd features.
Anyway, I'm not depressed but still confused about what to do. I'm worry about taking meds again because the last times I tried I made a mess, and worry about not taking them because I have to study for my PHD.
Ok, I'm a little depressed ;-), and I'm complaining, which is one of my favourite hobbies. Your first experience with Wellbutrin seems comparable to mine, I guess that I could start to tolerare antidepressants if I take a mood stabilizer. I'm trying to make some order in my disoder ... I have four options and a question:
1. quit all the meds and psychiatry stuff and see what happens. Consequence: I'm likely to recover physically but having problems with studying.
2. see a psychiatrist I've heard that has been told me to treat people with herbs and so on. Consequence: probably a waste of time3. wait for my psychiatrist to come back (it's in the us now and he will be here again in two weeks) and follow his instructions without trying to cure myself without having the sufficient knowledge and mental health to do it.
4. see another psychiatrist before he comes back and listens to what he says.
question: do you know which are the syntoms of benzo withdrawal ?
Sorry for the disorganization of the post, but I guess you can understand ;-)
Posted by utopizen on February 15, 2004, at 22:33:54
In reply to only benzos ?, posted by francesco on February 10, 2004, at 16:12:54
> Is there someone who manages to do something with a 'monotherapy' with benzos ? It seems that they are the only thing that I can tolerate and that they improve all my syntoms (also lack of concentration and urological problems !) with no noticeable side-effects.
>It sounds bad, and if I were me hearing this from someone else, I'd not want to here it, but over the last week I've realized something. If I go of my Klonopin, like I had for the past three weeks, and start it again, I feel the terrific, non-anxious self I felt back when I wasn't using it at 3mg for a substitute for the Ambien I would never get scipted, when I was in the first 3 months of using it, before that magical calmness dissipiates.
So I'm thinking of just telling my docs I'd like to keep the Klonopin permanently at 1mg 3x/day, asking for Ambien somehow (my sleep doc has to cave in some day-- otherwise I'll never use his stupid CPAP machine for my apnea). And only using the Klonopin when I feel stressed, or feel like it's causing me to brood over my schoolwork to the point where I'm not accomplishing anything, or I have a discussion class, which is once per week.
Also, using Klonopin's great, because it gives you the short-term relief you need whiel having time to experiment with other meds. Have you tried Zoloft? I've tried pretty much every med but it, including three antipsychotics. I'm going to try Zoloft to add to my Klonopin, and then after a couple of months give it a booster of Abilify.
I've done med trials for over 2 years now, most of that time without Klonopin except for prn doses if that. Believe me, you want to explore all your options, even if you are on Klonopin, because eventually the Klonopin will not have the same effect. I wouldn't call it tolerance, because I take 1mg and I'm pretty sure taking more wouldn't do that much. But whatever it is, you want to reduce your net anxiety somehow, even if you plan on keeping Klonopin for life.
And use CBT. I was stupid enough not to once I got Klonopin from a new doc. CBT helps. And keep exploring new meds. I'm not convinced a single patient truly had their social anxiety reduced, but my psychiatrist laughed when I asked him if he ever saw a patient who was helped by an SSRI.
I'm trying Zoloft soon. Oh, and if you ever have a problem with your current doc, don't assume you won't either, the first thing the typical doc may say to you is "let's taper that K first." Your med trials aren't as exaustive as mine. I've even tried Buspar and the three antihistamines. Three antipsychotics. Wellbutrin, Effexor for 5 months at 400mg, Celexa for 5 months, Paxil not tolerated- insomnia. Neurontin for months at 3000mg or so a day, but it made me retarded, so I stopped. Lots lots more.
So if I try Zoloft, that's pretty much the last stab I can give before the trycyllics. But I've tried Remeron and Trazodone. I've tried to explain to my current doc that they're not for patients with stuffy noses, but he doesn't listen.
I've had some hell for the past few years. The one doc I once saw who gave me Ambien monthly I told him I didn't need it after a couple of months to make him feel like I wasn't a druggie. Stupid idea. Now I see a new doc who won't prescribe it. Will see a new doc soon.
Posted by francesco on February 16, 2004, at 7:21:38
In reply to Re: only benzos ? » francesco, posted by utopizen on February 15, 2004, at 22:33:54
Interesting story Utopizen. May I ask which is your main problem ? If it's just SP, and you haven't tried it yet, why don't you give MAOIs a chance ? I don't thing TCAs are so well indicated for SP but maybe secondary amines like desipramine may work ... My opinion of SSRIs is not that high ... I've been on TCAs for years and done fair well while I had only 'weird' experiences on SSRIs. It seems that a lot of docs in US consider TCAs as the last resort but here in Italy the situation is quite different. My previous p-doc told me that many of his patients seem to prefer the side-effects of TCAs rather than those of SSRIs.
May I ask you which was your experience with Effexor ? I'm thinking about it as the next med to try for my ADHD, but I've read a lot of bad reports so, I'm not very convinced.
Posted by utopizen on February 16, 2004, at 10:37:46
In reply to Re: only benzos ? » utopizen, posted by francesco on February 16, 2004, at 7:21:38
> May I ask you which was your experience with Effexor ? I'm thinking about it as the next med to try for my ADHD, but I've read a lot of bad reports so, I'm not very convinced.
>Mmmm... Effexor... I got super happy when my pdoc threw the first samples on my lap. That's about it. Some times when I got up too fast from my chair, I had a weird blackout for a split second. That was my reminder that I take an antidepressant. I couldn't have sex, which was okay, because I didn't get any because I had social anxiety anyway. But the downside is for ADD, having no release at all is very distracting.
Did it make me better for my ADD? I highly doubt it. Not with the number of all nighters and pathetic procastination I had to deal with. I was on 400mg, and didn't feel a damn bit of difference on it.
Posted by francesco on February 16, 2004, at 17:21:06
In reply to Re: only benzos ?, posted by KellyD on February 10, 2004, at 16:51:22
Hi Kelly, may I ask which benzo do you use and which supplements ? I find xanax mood enhancing and I think it helps also with my 'brain fog'. This disturbs me since I thought anxiety was not a problem of mine and that benzo were contro-indicated for adhd-related problems. I found true the opposite.
Posted by Chairman_MAO on February 16, 2004, at 18:51:35
In reply to Re: only benzos ? » KellyD, posted by francesco on February 16, 2004, at 17:21:06
Your "disturbing thought" is correct: psychiatric disorders may just be artifical kinds. That is, only existing in the minds of those who believe in them. I've heard arguments that they are natural kinds, too. I used to know metaphysics when I was YOUNGER, isn't that sad?
Speaking of memory loss, are you sure that the xanax isn't helping your memory because you've become somewhat used to having benzos in your system by taking the oxazepam? As I believe I told you previously, impaired concentration is a feature of benzodiazepine dependency, and you might find that if you quit the benzos, went on something for ADHD, and toughed it out (for 6 to 12 months), you concentration might be superior to what it's like on the benzo right now. Hard to say though, and I wish you luck finding it out. But if a benzo makes that much of a difference over the long haul, it only makes sense to take it.
Cheers!
Posted by utopizen on February 16, 2004, at 21:53:47
In reply to Re: only benzos ? » francesco, posted by Chairman_MAO on February 16, 2004, at 18:51:35
Had this argument with my psychiatrist last year. He gave a funny look after I told him I felt smarter when giving my presentation on Klonopin.
All benzos will reduce your IQ, whether you have anxiety or ADD or not. The difference is, your ADD and anxiety both affect reaction time, a key component to determining your IQ. Reduce reaction time, reduce IQ. It's that simple.
In other words, if your ADD or anxiety is so clinically signifigant you're getting a benzo, chances are your IQ will increase, because it is affecting how you think so much that reducing this condition helps your IQ.
You go down a few points, but your disorders already have you so down already it's actually a net gain!
I had to look it up in the American Textbook of Psychopharmacology, which virtually said the same thing I told my doc (hey, it made common sense to me!) "Benzos certainly do decrease IQ. Yet anxiety itself reduces one's IQ, in effect allowing the patient with anxiety to .... blah-blah-blah."
Posted by Chairman_MAO on February 17, 2004, at 7:49:10
In reply to The Reason why Benzos Make You Feel Smarter, posted by utopizen on February 16, 2004, at 21:53:47
Alternatively, this could be one of the many pieces of evidence that IQ tests are largely bunk when it comes to performing real-world, complex tasks, and that intelligence on a whole is not quantifiable at all. My grandmother helped develop the IQ test With Max Weschler, and yet its telling me all the time that there is no such thing as "normal" when it comes to people ...
I am taking Wellbutrin now--the only thing that my doctor would give me for attention besides Strattera, which made me impotent--which is starting to elevate my mood and giving me about 3% more energy than I used to have at the expense of increasing my anxiety level enough to make me feel MORE distracted instead of less. I do love suffering, whooopie!
Posted by Viridis on February 18, 2004, at 0:58:43
In reply to Re: only benzos ? » francesco, posted by Chairman_MAO on February 16, 2004, at 18:51:35
I've seen no evidence that benzos decrease IQ or critical thinking at therapeutic doses, and I certainly perform better while on them. My IQ test scores are about the same as (or higher than) they were pre-benzo, even when I was doing quite well. I don't buy this at all, and in any case, anxiety/depression certainly decreases cognitive ability.
Posted by utopizen on February 18, 2004, at 16:21:49
In reply to Benzos and IQ etc., posted by Viridis on February 18, 2004, at 0:58:43
> I've seen no evidence that benzos decrease IQ or critical thinking at therapeutic doses, and I certainly perform better while on them. My IQ test scores are about the same as (or higher than) they were pre-benzo, even when I was doing quite well. I don't buy this at all, and in any case, anxiety/depression certainly decreases cognitive ability.
Well, your last line was the point I was making.
You can't actually "feel" IQ, nor can IQ be tested so consistently you can determine precisely what drug is affecting or not affecting it. On any given day, given a battery of IQ tests, all without drugs, or disorders, your IQ will vary. This is according to my neuropsychological evaluating doc who gave me my psych eval for ADD. It was 8 hours. How many times do you take your IQ? I booked that 5 months in advance, and it cost $2000.
Also, you're not suppose to take meds the day of testing... maybe AD's, perhaps... if it's stabalized. But certainly, why would you take a benzo the day of the test?
Anyway, it's clinically established benzos decrease your IQ. Klonopin is less signifigant, I can't "feel" impaired thinking on it, if anything, I'm smarter in my net gains for my IQ not being affecting by my anxiety. But Xanax definitely let me "feel" stupider.
This is the end of the thread.
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