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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 Michael Bell on December 6, 2005, at 0:42:55
Where are all the ***true*** anxiety meds!!!Klonopin and other benzos have been around for decades, right? Now, K has its downsides (like slight depression after long term use) but there's no question it is very helpful for a lot of people with SP, GAD, Panic, etc. And everyone knows its mechanism of action. So why is it taking so long to come out with anxiety meds? I'm talking GABA-a subreceptors here.
Why is ocinaplon the only one to address the alpha-2 subunit issue??? And of course, it's on hold.
Finally, finally scientists have shifted attention to GABA as a promising transmitter for anti-anxiety, anti-parkinson's action.
Nardil, Klonopin, Alcohol, GHB - all extremely effective for SP, and all with 1 thing in common - significant effects on the GABA system.
The pipeline of drugs continue, and still we wait...
Posted by med_empowered on December 6, 2005, at 2:06:38
In reply to Here's what I don't get!!!, posted by Michael Bell on December 6, 2005, at 0:42:55
There was this philosopher--Kuhn, I think--who made an interesting observation: science doesn't progress in a linear sense. Its not as if one day scientists think X, then there's better data, and they move onto Y. Rather, science has a very real orthodox, idealogical component to it; X is the accepted idea b/c of data and outside factors--in psychiatry, I imagine a lot of these would be money related, like money to research certain compounds or money spent pushing certain drugs. Then idea Y is accepted, and its not an *evolution* its a *revolution*. So..right now, the most popular anti-anxiety compounds are antidepressants, with the antipsychotics gaining a lot of ground. As the focus shifts more towards GABA compounds, you'll see the data change, too; suddenly there'll be interest in augmenting old therapies, reviving the benzos, etc. So..instead of layering knowledge, building a foundation of data, its more of a complete "paradigm shift"--a fundamental change in the way an issue or problem is understood (and, therefore, dealt with).
Posted by the anger without on December 6, 2005, at 2:08:57
In reply to Here's what I don't get!!!, posted by Michael Bell on December 6, 2005, at 0:42:55
Hi...first time here and don't know if I'll be doing everything right but bear with me please.
For many years I was on tegretol 1200 mgs re a facial nerve disaster brought on by a dental injection...this was to calm the twitching etc..plus 60 mgs of prozac for severe depression.
Now, for about the past eight years I've been on 20 mgs of prozac. I decided to stop it as I wasn't really 'depressed'but was having horrible outbursts of anger...usualy directed at my daughter (16) and her Dad. I turned into Satan...vulgar and yelling and saying hurtful crazy things. Anyway, went to a Dr. after having no drug for two months but increasing anger and she gave me clonazepam .5 twice daily. I'm not as 'possessed', but waiting to see a psychologist...I'm wondering if I shouldn't be seeing a shrink as I want to be 'labelled' correctly re the right drug. My family all suffers from some form of depressive illness/bi-p
etc. I really feel this 'anxiety'(lol) is not just the start of menopause and I'm really frightened.
I'm a total nutcase..yes somewhat depressed..but more angry. (daughter is wonderful so don't know why she takes the brunt of this) I actually raised my hand to her and threw a magazine at her one day...for nothing really..and had a case or two of road rage...I'm worried I'll hurt someone
re my lack of control. The clonaz is taming me a bit, though the depression seems more tears of late...it's only been two weeks. Maybe I'll get even better. What causes this rage? I get the feeling the new Dr. thinks I just need someone to talk with while I'm feeling I must have a brain tumor(wishful thinking) (I mean I need a solid diagnosis) to cause such a difference in my personality. I'm feeling afraid and ashamed and in dire need of help. Please ...any suggestions?
Posted by the anger without on December 6, 2005, at 2:27:57
In reply to Dear God what's Gad more questions, posted by the anger without on December 6, 2005, at 2:08:57
OH, and I can't sleep on this med. Is wellbutrin available in Canada? Also...was having suicidal thoughts on prozac during the later stages of using the drug...these seem to have subsided.
Do you ever feel just incapable of accomplishing anything..no matter how menial a task? But I'm skipping the issue here..it's RAGE. Real. Terrifying. Please help me ask the Dr. for the right tests/specialists/meds...menopause just can't be this terrible.
Posted by med_empowered on December 6, 2005, at 3:50:04
In reply to Re: Dear God what's Gad more questions, posted by the anger without on December 6, 2005, at 2:27:57
hey! OK, I'll admit: I've been kind of too embarassed sometimes to post about my angry feelings. Or tell a shrink about them. Its like..youre anxious; OK. You're sad; OK. But..you start throwing things, getting angry getting..well, crazy...and suddenly things feel different. I can't tell you what exactly will help you with the rage. I'm learning to process it myself--writing helps, so does meditation, proper nutrition, exercise, and trying not to focus on the future. And I get that thing where you feel like you can't do **anything**...I've learned that sometimes just brushing your teeth can be an amazing accomplishment. The good news is that everytime you do that--everytime you brush your teeth, get out of bed, shower, whatever--you win a little bit. You take some of your life back from that gaping, dark vortex of misery, fury, and despair that is depression. So..that's my uplifiting thought for the day.
Re: meds...I'd avoid antipsychotics (they feel like chemical lobotomies...TRUST ME). Stimulants should probably be avoided. Benzo use should be minimal; higher doses can make rage worse, which no one wants. Unfortunately, antidepressants can sometimes do the same thing. So..my advice would be maybe a mood stabilize, like Trileptal/Tegretol, maybe Keppra, Depakote, or Lamictal (lamictal runs the risk of inducing hypomania, but still might be useful). Personally, I'd keep the doses pretty low; the idea shouldn't be to **elminate** the anger, or even diminish it, really...the goal should be to help you *deal* with the anger, so self-help stuff you do and talk therapy will be more effective.
I know how awful it feels to take out your rage on loved ones and then live with the consequences. My anger makes me cold, cynical, and mean; I fear I have severely damaged my relationship with my best friend. I'm working to be a better friend, but its hard. I guess all I can say is that alot of this probably needs to be done at an emotional/mental level, not at the biochemical level (minimize meds)..that said, it certainly can be done; I think I've made some progress so far, though it isn't quite at the night and day point.
Good luck!
Posted by the anger without on December 6, 2005, at 15:25:59
In reply to I get ANGER, too, posted by med_empowered on December 6, 2005, at 3:50:04
Thanks med-empowered...you have told me what I what/need to hear..there is light after dark.
Went my MD today..she increased my cyclowhatever
up two pills...another ten mgs as I wasn't able to sleep. She wants me to do Celexa as well come the new year. Do I have to live on meds to be 'normal'? I'm still in the dark ages re keeping mental health in the closet (a good catholic guilt thing) I'm an atheist now and still can't accept that I have 'mental illness'.
Maybe I'll take a step now and go brush my teeth.
Small steps...must lead someplace even if it will take a while. I'm very unfamiliar with the drugs you mentioned so will do a little research. Seeing a psychologist Dec 23. Daughter in for jaw surgery 9th and thru the 'high-low-days' so maybe that will help take my mind off of 'me' a bit.
I just can't figure out how one day...or for years I can live without this fury and then suddenly I'm possessed. Having someone to confide in may work..as well as concentrating more on today that constantly thinking and preparing for the future. I do have a mulitiude of things to be angry sorrowful hurt about, but I though all that was behind me. Maybe I just am looking for some attention instead of giving it all the time...odd way of doing it though I'd have to say.
I live a really different life than many people and I think I'm very angry about that...I want to be 'normal'..gee that word is overused. Anyway, thank you for giving me some hope and some ideas...ir looks like you have discovered a lot about what works for you. Thanks for sharing.
Posted by Phillipa on December 6, 2005, at 19:12:28
In reply to Re: I get ANGER, too, posted by the anger without on December 6, 2005, at 15:25:59
Meds affected me entirely differently during peri and menopause. I could not tolerate any of the SSRI's and now they do nothing for me. Even at very low doses during that time horrible side effects. The only meds I trust are benzos. They have been around longer than most without anything harmful except they say they are addicting. If you do not abuse them then only your body is used to them. And the same thing happens with SSRI's so what is the difference? Fondly, Phillipa
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