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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by andie1970 on May 10, 2004, at 10:04:31
Hi everyone,
I know there will be many different opinions on this, and am interested in any of them! I am talking to my doctor this week about a new medication, and am so tired of the weight gain from the many SSRI's and none has worked for my anxiety anyway. I'm curious to know if anyone has found a medication that has not caused any weight gain (or they have lost weight?!) and I don't care what it is, SSRI, or anything else, but has worked for them, including a cocktail you want to write about. I am so sick of anxiety, I just feel like crying. Again. Social anxiety, Generalized, a little OCD, phobic, so there's a lot there! what fun. I'm feeling a little disheartened at the moment, excuse me. I was just reading about Gabatril at this site and am interested because it says it didn't cause weight gain (I was considering neurontin until i read about weight gain there too!) I read about some horrific side effects at high doses, which scare me, but maybe at low doses? I read about tranquil-q or something, which i can't tell if it's legal anymore, and costs a lot, and then read about ultram, don't know the status on that, and don't know if my doctor will prescribe it. It is a new doctor, and my old doctor was fine about prescribing clonazepam, which worked well, and i never became addicted, but this new doctor seems to think i should go on an SSRI. of course he isn't a single 30 something woman, so weight gain's not an issue for him! I want so much to find out something I can tell him about on Wednesday that he won't immediately dismiss and send me off for yet another ssri, because that's all he seems to want to write off for me. If anyone has any great experiences to write about, I will be so grateful!!!!!!!!!
Posted by harryp on May 10, 2004, at 10:55:16
In reply to best anxiety meds without weight gain?, posted by andie1970 on May 10, 2004, at 10:04:31
clonazepam and the other benzos aren't known for causing weight gain.
I would suggest clonazepam, and it sounds like it was already working for you.
In general, the SSRI's do not appear to be very good antianxiety drugs. MAOI's can be great for anxiety, particularly Nardil.
The benzos (like clonazepam) are still the safest and most effective drugs for anxiety, and have minimal side-effects. They are the only drugs besides Parnate (which isn't a "reliable" anti-anxiety drug) that can control serious anxiety reliably without weight gain.
One can become physically dependent, but if you need the drug anyway that shouldn't really be an issue. The main problem is with people who keep raising their dosages. To prevent tolerance, you should always use just enough for your symptoms and no more.
If you do need to go off a benzo, you just taper off slowly. It is not a big deal.
I have taken lorazapam (Ativan) for three years as needed for very severe anxiety episodes. I have never had a problem with it. Right now I take about 2 mg/day. During the holidays I would need up to 5! I have not ever had a problem with tolerance or withdrawal when I lower the dosages. I think this is because I always take only the minimum amount needed to get rid of the anxiety symptoms.
Posted by andie1970 on May 10, 2004, at 12:01:26
In reply to Re: best anxiety meds without weight gain?, posted by harryp on May 10, 2004, at 10:55:16
I'm sorry, I didn't write my post right. I meant to say that my new doctor seems to think benzos are not the way to go and SSRI's are, unfortunately. I have been using clonaz for a few years successfully, and am nervous about what he wants to change me to, and no refilling my clonaz anymore. This seems to be where he was leaning last time we talked, and he seems set on SSRI's being the best thing for me, though I have felt fine with clonaz. He thinks an SSRi will end the anxiety long term, and the benzos won't. I have yet to hear of anyone who has had better luck on SSRI's either. Anyway, harry, i agree with you on the clonaz, and that would be the way i would go given the chance! Thanks for writing :)
Posted by Mimi on May 10, 2004, at 20:48:15
In reply to best anxiety meds without weight gain?, posted by andie1970 on May 10, 2004, at 10:04:31
Posted by snapper on May 10, 2004, at 23:53:06
In reply to BUSPAR IS THE ANSWER (nm), posted by Mimi on May 10, 2004, at 20:48:15
Mimi, forgive me if I sound ignorant,but if Buspar was 'THE ANSWER'...why isn't it being highly touted here on PB or anywhere else for that matter...do you know something that the rest of us in the socially anxious world do not know?
Snapper
Posted by chemist on May 11, 2004, at 2:34:24
In reply to Re: BUSPAR IS THE ANSWER, posted by snapper on May 10, 2004, at 23:53:06
> Mimi, forgive me if I sound ignorant,but if Buspar was 'THE ANSWER'...why isn't it being highly touted here on PB or anywhere else for that matter...do you know something that the rest of us in the socially anxious world do not know?
> Snapperfor what it's worth, i concur: please share your experience with us...all the best, chemist
p.s. my bout with buspar was equivalent to taking a placebo....
Posted by invisiblemanpa on May 11, 2004, at 9:14:03
In reply to Re: BUSPAR IS THE ANSWER » snapper, posted by chemist on May 11, 2004, at 2:34:24
I was prescibed buspar twice for severe socail anxiety. The first time it helped some for about 4 months, then no effect at all. The second time, my psy added while I was on effexor and the buspar
made me very sick, so I dumped it in the toilet. Why bother., I have read numerous times that it is common to have only short time help. I still have found that lorazepam or xanax to be the best to control all the symptons of socail anxiety. But yes they are addictive and I have found Lorazepam (Ativan), to start loosing it's effectiveness over time, which is what I am dealing with now....good luck socail anxiety is very real and very embarrassing..it has cost me a lot at work and many other socail settings. I have been able to take 1 mg of Xanax and get up and teach a class, lead a meeting, sit through church...etc.....what is worse...to hide in your house with the curtains closed or addiction to prescriptions?
Posted by andie1970 on May 11, 2004, at 11:00:52
In reply to Re: BUSPAR IS THE ANSWER/IS NOT THE ANSWER!!, posted by invisiblemanpa on May 11, 2004, at 9:14:03
I wholeheartedly agree! I was able to talk to a man who wanted to ask me out yesterday only after taking xanax and would before have been shaky and blushing, and would have not talked to him! I just wish my doctor would realize this.
I took a class recently on medications, about a year ago (so of course there may be a lot more meds out there today, fingers crossed) and I learned something I never knew before, and my wish is that is it can help anyone out there taking buspar, then great, because buspar did nothing for me (yes, it seemed like a placebo!) I read that when taken with grapefruit, the effect skyrocketed. i don't know why, something about what it metabolizes, or something, sorry i can't tell you more. But grapefruit is a strange thing, bad effects and good effects on different medicine, but unfortunately they don't seem to know enough yet, and only sometimes labal that on a bottle. Anyway, for those of you who do like buspar, grapefruit may help. if it does, please let us know! I would love to hear a buspar success story too! Thanks :)
Posted by pseudonym on May 11, 2004, at 11:46:11
In reply to BUSPAR IS THE ANSWER (nm), posted by Mimi on May 10, 2004, at 20:48:15
Buspar did nothing to cure my social anxiety, bottom line. While it may have the right biochemical idea, its execution is terrible. Gepirone (a compound now in registration by Organon known as Variza), uses the same concept, 5HT1-A receptor agonism, only it binds more stronly to both pre and post synaptic receptors.
Posted by zeugma on May 11, 2004, at 21:25:18
In reply to Re: BUSPAR IS THE ANSWER, posted by pseudonym on May 11, 2004, at 11:46:11
for what it's worth, i am a severe anxiety suffere, and clonazepam and buspirone are in entirely different categories. For me, for a drug to qualify as an 'anxiolytic,' it must at least be able to block panic attacks, and buspirone has been proven not to do this. It is not an anxiolytic, and when my pdoc referred to it as such i corected him: 'it's not an anxiolytic, it's some kind of antidepressant.' I would agree that it belongs in thaqt class of antidpressants that have no efficacy in panic disorder, a category that includes Wellbutrin and very few others (prehaps, the generally 'weaker' AD's such as trazodone, Serzone, etc. As another poster mentioned, Buspar has terrible execution, but i attribute it to its wretched pharmacokinetics (very short half-life, like another weak AD, moclobemide). Nonetheless , I take it because it does have some efficacy in depression and helps me sleep.
Posted by Racer on May 12, 2004, at 8:52:33
In reply to best anxiety meds without weight gain?, posted by andie1970 on May 10, 2004, at 10:04:31
Take this with a grain of salt, because I suffer major depression with anxiety, not the stand alone anxiety you're looking for help with, but Effexor helped my anxiety. In my case, it took a combination of Effexor and Prozac to do anything about my depression, so I don't know which drug was involved in the other experiences I had -- long term weight gain and drug poop-out -- but I was at a relatively high dose of Effexor, and have had a fair amount of weight gain on SSRIs (like Prozac) The anxiolytic effects of the Effexor, though, kicked in from the start with the lower doses of Effexor, so it may be that a low to mid dose of Effexor would help you, and it may be that the long term weight gain I experienced was from the Prozac or the higher dosage of Effexor or even some combination of the two drugs.
If your new doctor -- is he a pdoc, by the way, or a GP dabbling in this? -- wants to go the anti-depressant route, it might be worth giving Effexor a try. (Might not, but it wasn't nearly as bad as the SSRIs have been for me. Just not effective enough on my depression.)
Good luck
Posted by invisiblemanpa on May 12, 2004, at 9:37:15
In reply to Re: best anxiety meds without weight gain?, posted by Racer on May 12, 2004, at 8:52:33
Interesting response. At what levels of Effexor are you on now if I may ask? My psy. swears that effexor is the best anti depressant with crossover effects for anxiety. That I am not sure of in the long term, as it seems to have pooped out for me. I gained 25 pounds on Effexor after being thin and in shape all my life. Now I can't drop a pound, South Beach Diet or Weight Watchers are no help either and I still exercise everyday.
As I posted earlier Buspar is a complete waste for depression or anxiety. The only thing that has every truely helped me with being able to deal with severe socail anxiety is Ativan or Xanax
and we all know what happens with addiction...what is worse?
Posted by Racer on May 12, 2004, at 11:12:11
In reply to Re: best anxiety meds without weight gain? I agree, posted by invisiblemanpa on May 12, 2004, at 9:37:15
I'm no longer on Effexor. Since my primary problem is depression, and it stopped working for that, I stopped it. The anxiolytic effects started virtually from the first day, at 37.5 mg, but the antidepressant effects -- mild though they were -- didn't kick in below 225, which was then said to be the highest therapeutic dose. The addition of 10mg Prozac was enough at first to keep the depression at bay, but within about 2 years it was back. I stayed on it for 4 or 5 years, though, before I finally gave up on it.
I did gain weight, as I said, but I can't say whether that was the Effexor or the Prozac or some other factor. I can say that, as soon as I got off the drugs, about half the weight dropped off on its own, with no changes made on my part. The rest of the weight dropped off when the next depressive episode hit...
Posted by andie1970 on May 13, 2004, at 0:07:21
In reply to Re: best anxiety meds without weight gain? I agree, posted by Racer on May 12, 2004, at 11:12:11
Racer,
Just wanted to answer your question. He's a GP and I think his knowledge is limited. Maybe I should find out about getting referred out to a shrink who knows about this stuff, because I may bail out on seeing him, knowing all he did before was push the SSRIs, and asked me, would I rather gain weight, or be anxious? I understand what he is saying, but it is barely empathic to say that, knowing they are both so difficult to deal with. Anyway, thanks to everyone for your suggestions! If I don't ask him about gabatril, I will tell him how many others suggest staying on the benzos, I wish he knew what it was like to be socially and generally anxious :(
Posted by Tony P on May 13, 2004, at 20:05:31
In reply to Re: BUSPAR IS THE ANSWER/IS NOT THE ANSWER!!, posted by andie1970 on May 11, 2004, at 11:00:52
I am one of the (few?) Buspar success stories. It worked really well for me for many years, but as Zeugma posted, more like a mild A/D, no good for GAD or panic attacks. I felt there was some anxiolytic effect in that I could handle a stressfull day without coming home and blowing up at the wife or kids. BTW this effect happened immediately for me, about 1-2 hours after each dose, not after 7-10 days as stated in the monograph. But it was certainly nothing like the effect of the benzos.
It also proved to work really well for me with Serzone as an A/D enhancer, before that effect became widely known, giving me extra energy and positive outlook as well as stopping the stress-induced reactive depression I was getting.
Since I've been on Lamictal (currently 300 mg/day), the buspar seems to have no effect whatever, so I've dropped it. But it was good while it lasted! It seems this is one of those meds that either works really well for a person or does nothing at all. My experience with the effectiveness with Serzone versus Lamictal suggests it may also depend a LOT on what else you are on.
On the grapefruit issue, I've tried that, and the effect for me was noticeable but relatively small. It's worth trying (at least 8 oz of real grapefruit juice, and on an empty stomach worked best). My pharmacist also said that despite the warning the grapefruit effect is not really a big concern (as it is for some meds), and Buspar seems to have a pretty wide tolerance margin.
Tony
> I wholeheartedly agree! [snipped] ...I learned something I never knew before, and my wish is that is it can help anyone out there taking buspar, then great, because buspar did nothing for me (yes, it seemed like a placebo!) I read that when taken with grapefruit, the effect skyrocketed. i don't know why, something about what it metabolizes, or something, sorry i can't tell you more. But grapefruit is a strange thing, bad effects and good effects on different medicine, but unfortunately they don't seem to know enough yet, and only sometimes labal that on a bottle. Anyway, for those of you who do like buspar, grapefruit may help. if it does, please let us know! I would love to hear a buspar success story too! Thanks :)
Posted by patricia leahy on May 14, 2004, at 22:36:42
In reply to Re: BUSPAR IS THE ANSWER » snapper, posted by chemist on May 11, 2004, at 2:34:24
> I to took Buspar for awhile a couple of years ago, made my eyes feel jerky and felt a buzz like feeling when i turned my head!!! good luck if it works for you
> Mimi, forgive me if I sound ignorant,but if Buspar was 'THE ANSWER'...why isn't it being highly touted here on PB or anywhere else for that matter...do you know something that the rest of us in the socially anxious world do not know?
> > Snapper
>
> for what it's worth, i concur: please share your experience with us...all the best, chemist
> p.s. my bout with buspar was equivalent to taking a placebo....
Posted by Mimi on May 14, 2004, at 23:33:26
In reply to Re: BUSPAR IS THE ANSWER » snapper, posted by chemist on May 11, 2004, at 2:34:24
Okay chemist and snapper and all other interested parties:
I suffered from depression and social anxiety for many years. The anxiety flowered into full-blown panic attacks. I was very shy and would always cry in the corner at parties--my whole life.
Now, I take Celexa 20mg. for depression and BUSPAR 15mg 1 or 2 times a day and can enter any social situation with confidence and grace. If I have a particular taxing social engagement, like modeling on a runway, I pop a Buspar 20 minutes before I'm on. It works miracles for me.
It's my feeling that many people are jaded to the effect of these psychotropic meds, but I also know that I am more med-sensitive than most people. I did take Klonopin but that was way too strong for me and knocked me for a loop; I might as well have been unconscious 24/7.
That's all I can tell you folks. Thanks for engaging.
Mimi
Posted by chemist on May 14, 2004, at 23:43:39
In reply to WHY BUSPAR IS THE ANSWER (for me), posted by Mimi on May 14, 2004, at 23:33:26
> Okay chemist and snapper and all other interested parties:
>
> I suffered from depression and social anxiety for many years. The anxiety flowered into full-blown panic attacks. I was very shy and would always cry in the corner at parties--my whole life.
>
> Now, I take Celexa 20mg. for depression and BUSPAR 15mg 1 or 2 times a day and can enter any social situation with confidence and grace. If I have a particular taxing social engagement, like modeling on a runway, I pop a Buspar 20 minutes before I'm on. It works miracles for me.
>
> It's my feeling that many people are jaded to the effect of these psychotropic meds, but I also know that I am more med-sensitive than most people. I did take Klonopin but that was way too strong for me and knocked me for a loop; I might as well have been unconscious 24/7.
>
> That's all I can tell you folks. Thanks for engaging.
>
> Mimi
>
>
mimi, it is always so positive to hear a story that ends well! thank you for you input, i hope everyone can glean the appropriate indications from your post...all the best, chemist
Posted by andie1970 on May 17, 2004, at 10:24:53
In reply to Re: BUSPAR IS THE ANSWER (success 4 me) » andie1970, posted by Tony P on May 13, 2004, at 20:05:31
Can you tell me what Lamictal is for? I read it was for seizures I think, and bpd, is that right? But can it be used for anxiety or depression? serzone is new to me also, but I read it is for depression, just a minute ago. Does anyone know if it is for anxiety as well as an anti-depressant? Also, does anyone know if either or these has an effect on weight? Have any of them effected your weight, Tony? Thanks for the info!
Posted by andie1970 on June 7, 2004, at 9:32:47
In reply to Re: best anxiety meds without weight gain?, posted by Racer on May 12, 2004, at 8:52:33
I wanted to thank you all for your posts and want to bring them to my new doctor. Went to see two nurse practitioners, both against benzos. Feeling so down about it, because one thing that really seemed to work for social anxiety was taking one half of my xanax. I even went for coffee with a man, that was amazingly courageous for me, since at one time, I barely left home! but they're covinced that benzos lead to addiction for everyone, and not the way to go! they are sending me to the new doctor, but they all work together, so i don't feel too excited to see him. I wanted to print out some of your posts about how well you all did on benzos, so far the only thing that made a difference for me (even all the things i tried, celexa, luvox, did nothing anxiety wise, just gained a lot of weight, terrific for a single woman! or anyone, i should really say). Anyway, if anyone has seen any scientific articles on the BENEfits of benzos, i would love to see them, because i wonder if this guy won't take them seriously unless their "scientific." Anyway, if not, thanks again, and good luck to you all!
Posted by invisiblemanpa on June 7, 2004, at 10:12:31
In reply to Re: best anxiety meds without weight gain?, posted by andie1970 on June 7, 2004, at 9:32:47
Hey! They are only worried about being sued. Yes they are addictive. Which is worse being a shut in and having your career go down the tubes or taking medicine that really helps a medical condition. I have dealt with socail anxiety my whole adult life. Before I knew I could get help I would drink before socail gatherings..at work I would run....terrible way to live. I have also been thru the depression cycle which seems to go hand in hand and none of the anti depressants with so called cross over effects really have any noticable benefit except maybe some of the continual worry goes away but the fright and flight symptons still arise without benzos. I know what you mean about dating. I am able to take an ativan an be in a socail situation or lead a group meeting at work. Otherwise I would be a mess. It is the truth. If my psy dr. quits giving me ativan I will go to someone else. Addiction....there are much worse things to be addicated to. I don't take them for a high. I use it to be able to function like a normal person (hmm what is normal)Good luck, ativan , xanax...all work and all are addictive....but.....it's better than smoking!!!
Posted by Viridis on June 9, 2004, at 2:26:15
In reply to Lawyers have the docs running scared of Benzo use » andie1970, posted by invisiblemanpa on June 7, 2004, at 10:12:31
If you're not using benzos to get high, you're not increasing the dose on your own, and they're not disrupting your life, then you're not addicted. You're probably medically dependent, just like many people taking antidepressants, blood pressure medications, etc., which means that if you quit you have to do so slowly.
It's strange how so many people (including doctors!) use the word "addiction" for benzos, when this is really pretty rare for those with serious anxiety disorders. If someone has trouble coming off an antidepressant (which can often be worse) they call it "discontinuation syndrome". And when was the last time you heard someone call a diabetic an insulin addict?
This is the end of the thread.
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