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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 37. Go back in thread:
Posted by rfs on January 1, 2006, at 7:25:49
In reply to Re: testing » rfs, posted by ed_uk on December 31, 2005, at 12:40:53
Posted by rfs on January 1, 2006, at 7:27:38
In reply to Re: testing » rfs, posted by ed_uk on December 31, 2005, at 12:40:53
> Hi Ray
>
> Why did your doc want to add Wellbutrin? ........because of the side effects of Effexor, or because Effexor alone wasn't sufficient as an antidepressant?
>
> EdHi Ed,
For both of those reasons. I was complaining about social anxiety also. Since I have been on Effexor for 9 years I figure whatever Combo I take will include Effexor. If I remember correctly, I was also feeling somewhat lethargic at the time.
So I ended up on 300mg, of effexor and 150mg of wellbutrin XL
Before AD, I experienced the following.
anxiety
depression
social phobia (Bunch of other phobias also)
OCD symptoms, otherwise I was fine LOL.
The AD have helped a lot.Before I ever took any AD, I would avoid people. When I began taking AD I had no problem being around others except I would hardly speak.
I don't know if this makes sense, but I think the ideal combo would be an AD + anti anxiety med combined with a stimulant.
History
I am 53 began taking AD at 43.
Paxil 50mg. 1 year
Effexor 300 mg. 9 years ( added Wellbutrin)
Klonopin 2-3 times a month.
Brief trial on prozac, remeron for sleepAny ideas on what meds might be better.
Thanks,
Ray
Posted by ed_uk on January 1, 2006, at 13:08:53
In reply to Re: testing » ed_uk, posted by rfs on January 1, 2006, at 7:27:38
Hi Ray
So you have you been taking Wellbutrin XL 150mg since December 28? How are you finding it so far?
Regards
Ed
Posted by rfs on January 1, 2006, at 20:49:07
In reply to Re: testing » rfs, posted by ed_uk on January 1, 2006, at 13:08:53
> Hi Ray
>
> So you have you been taking Wellbutrin XL 150mg since December 28? How are you finding it so far?
>
> Regards
>
> Ed
>Hi Ed,
I think it is to early to say for sure, however I do find myself doing more during the day, which is better then just sitting around and thinking about doing things. I think I participate more in conversations. If I get up to quicly I get slight ly light headed
I have increased my klonopin use.All in all,I would say so far so good, but only time will tell
Ray
Posted by ed_uk on January 1, 2006, at 23:17:07
In reply to Re: testing » ed_uk, posted by rfs on January 1, 2006, at 20:49:07
How is it affecting your anxiety and insomnia?
Ed
Posted by rfs on January 2, 2006, at 5:18:56
In reply to Re: testing » rfs, posted by ed_uk on January 1, 2006, at 23:17:07
> How is it affecting your anxiety and insomnia?
>
> EdHi Ed,
I have been sleeping better (Klonopin maybe) I feel a little more alert,and confident which is good. but I have been on vacation for 10 days so that reduces my anxiety level anyway, plus the klonopin is probably helping, even though I take a small dose .5mg not everyday I notice that I want to become involved in a group conversation, I will ask questions etc.
I still worry about becoming dependent on the klonopin (I have asked my Doc about other anti anxiety meds that are not addictive, he thinks Klonopin is best for me, and feels that I am not the type to become addicted based on my personality???. He also prescribes small amounts.Thank's again,
Ray
Posted by ed_uk on January 2, 2006, at 5:34:28
In reply to Re: testing » ed_uk, posted by rfs on January 2, 2006, at 5:18:56
Hi Ray
>I am not the type to become addicted
What are you afraid of? That you will abuse/misuse the Klonopin? That you will suffer withdrawal symptoms when you stop the Klonopin? Your personality does not affect the risk of withdrawal symptoms.
Regards
Ed
Posted by rfs on January 2, 2006, at 6:31:06
In reply to Re: testing » rfs, posted by ed_uk on January 2, 2006, at 5:34:28
> Hi Ray
>
> >I am not the type to become addicted
>
> What are you afraid of? That you will abuse/misuse the Klonopin? That you will suffer withdrawal symptoms when you stop the Klonopin? Your personality does not affect the risk of withdrawal symptoms.
>
> Regards
>
> Ed
Hi Ed,You hit the nail on the head. I am afraid that I will end up abusing the Klonopin, and end up needing more & more. and ending up without any Klonopin and then going through withdrawal. I know that this is not completely logical, aince I am not afraid of the effect effexor has on many people (withdrawal difficulties),plus I am not thrilled about the effects of Klonopin, (tiredness & memory loss) Only difference is that I was on Effexor for years before I heard about the discontinuation problems.
Ray
Posted by ed_uk on January 2, 2006, at 6:49:42
In reply to Re: testing » ed_uk, posted by rfs on January 2, 2006, at 6:31:06
Hi Ray
>I am afraid that I will end up abusing the Klonopin, and end up needing more & more.
When you say 'abusing', what do you mean? Different people mean different things.
Ed
Posted by rfs on January 2, 2006, at 8:06:26
In reply to Re: testing » rfs, posted by ed_uk on January 2, 2006, at 6:49:42
> Hi Ray
>
> >I am afraid that I will end up abusing the Klonopin, and end up needing more & more.
>
> When you say 'abusing', what do you mean? Different people mean different things.
>
> EdEd,
What I mean is that I am worried that I will become dependent on them, needing higher doses and needing them to sleep and function and that if I were to stop I would go into withdrawal. I get the impression that my Pdoc thinks that Klonopin is not to be used daily. I don't have a great deal of confidence in him. He seems overly conservitive, but I go to him because he is in my health plan.Ray
Posted by ed_uk on January 2, 2006, at 8:16:32
In reply to Re: testing » ed_uk, posted by rfs on January 2, 2006, at 8:06:26
Hi Ray,
Do you fear that you may use Klonopin in a way which is not medicinal? eg. taking higher doses than you need to relieve your anxiety, taking very high doses in an attempt to 'get high', taking it even when you don't need it for anxiety/insomnia etc.
Ed
Posted by rfs on January 2, 2006, at 11:53:19
In reply to Re: testing » rfs, posted by ed_uk on January 2, 2006, at 8:16:32
> Hi Ray,
>
> Do you fear that you may use Klonopin in a way which is not medicinal? eg. taking higher doses than you need to relieve your anxiety, taking very high doses in an attempt to 'get high', taking it even when you don't need it for anxiety/insomnia etc.
>
> Ed
Hi Ed,Yes, that does worry me.
Ray
Posted by ed_uk on January 2, 2006, at 12:39:47
In reply to Re: testing, posted by rfs on January 2, 2006, at 11:53:19
Hi Ray
Have you ever used any other drug in a similar manner? eg. alcohol
Ed
Posted by rfs on January 2, 2006, at 13:13:10
In reply to Re: testing » rfs, posted by ed_uk on January 2, 2006, at 12:39:47
Hi Ed,
When I was in my teens and early twenties I drank,(smoked pot infrequently) and took barbiturates to get high,(never at the same time) But I haven't drank, smoked, or poped anything to get high in about 30 years.
Ray
Posted by ed_uk on January 2, 2006, at 13:32:06
In reply to Re: testing, posted by rfs on January 2, 2006, at 13:13:10
Hi Ray
Do you ever feel tempted to take an excessive dose of Klonopin?
Ed
Posted by rfs on January 2, 2006, at 14:35:26
In reply to Re: testing » rfs, posted by ed_uk on January 2, 2006, at 13:32:06
> Hi Ray
>
> Do you ever feel tempted to take an excessive dose of Klonopin?
>
> EdEd,
If you mean in an attempt to get high, I would say no. When I am very very anxious, I have taken 1.5 mg. but only to reduce the anxiety.
Also on Jan. 11 I am flying to Florida (A phobia I hadn't mentioned). I wouldn't even think about getting on a plane without the Klonopin. I am not afraid of flying, just crashing.That might be the only time I feel a little high.Ray
Posted by ed_uk on January 2, 2006, at 15:18:27
In reply to Re: testing, posted by rfs on January 2, 2006, at 14:35:26
I get the impression that you're not going to misuse the Klonopin. Why do you think you are so worried that you might do?
Ed
Posted by rfs on January 2, 2006, at 17:42:02
In reply to Re: testing » rfs, posted by ed_uk on January 2, 2006, at 15:18:27
> I get the impression that you're not going to misuse the Klonopin. Why do you think you are so worried that you might do?
>
> EdHi Ed,
Probably because I worry about eveything. I was in therapy for 15 years, and about every month, I would tell my therapist that I thought I was dying from one thing or another. We would discuss the lack of logic and the fear would go away, until I came up with a new fear. Do you think Klonopin would help with that (OCD).
Thank,
Ray
Posted by ed_uk on January 3, 2006, at 14:38:53
In reply to Re: testing » ed_uk, posted by rfs on January 2, 2006, at 17:42:02
Hi Ray
>Do you think Klonopin would help with that (OCD).
Klonopin isn't generally particularly effective for classic OCD, although it is effective for most other forms of anxiety. What you describe might not be OCD. Have you been diagnosed with OCD?
Ed
Posted by rfs on January 3, 2006, at 17:36:07
In reply to Re: testing » rfs, posted by ed_uk on January 3, 2006, at 14:38:53
> Hi Ray
>
> >Do you think Klonopin would help with that (OCD).
>
> Klonopin isn't generally particularly effective for classic OCD, although it is effective for most other forms of anxiety. What you describe might not be OCD. Have you been diagnosed with OCD?
>
> EdHi Ed,
No I have never been diagnosed with OCD. Basically, I have suffered from panic attacks, phobias flying. In public restrooms, on the way outI would open the door by pulling my shirt over my hands to protect me from germs. I used to find being in a group of people (3&up)agonizing. Also since I was 7-8 I constantly worried that I was breaking some religious rule, and commiting terrible sins. I don't think thats possible in childhood. I also worried constantly about dying. I would have the thought that I would be better off dead. This last one was so much a part of me that I didnt think of it as being abnormal. since I never acted on it. After about 3 months of being on AD I realized that I was no longer having any of these feelings/thought. (almost) I still am terrified of flying and being in social situations does not make me that nervous, I just feel uncomfortable about not talking as much as the others and what are they thinking of me, Since I have started taking the Wellbutrin, I find myself talking to people a little more and I feel more motivated to do things. It has only been 7 days so It may take a bit longer. I also noticed that I am sleeping better maybe because I am more active during the day. By the way Ed I truly appreciate your input and I am sure that plays a part in how I am feeling.
Thanks
Ray
Posted by ed_uk on January 4, 2006, at 14:27:16
In reply to Re: testing, posted by rfs on January 3, 2006, at 17:36:07
Hi again
How did you find Paxil?
Ed
Posted by rfs on January 4, 2006, at 15:26:31
In reply to Re: testing » rfs, posted by ed_uk on January 4, 2006, at 14:27:16
> Hi again
>
> How did you find Paxil?
>
> EdHi Ed,
I remember the effects like it was yesterday. I had been taking Paxil for 9 days. I was doing an internship (School psychology)and I was sitting with my supervisor and a strange feeling came over me like my entire head was lifting and at first I was scared but within a few seconds I started to become relaxed and my mood was changing for the better. for a day or 2 that week I would say I was euphoric. I equate it to having the flu for a week or two and the first day or two that you feel better your just so greatful to be feeling better,then you fall into a routine of feeling well and stop appreciating it so much.
I was on Paxil for a year and changed to effexor because I was gaining a lot of weight and I thought effexor would give me more energy.(NE) At first I think my weight stopped increasing and maybe I had a little bit more energy, but as time went by I started gaining weight again and my energy level was about the same as on Paxil. Before I took Paxil, I was seeing a very good therapist, and making progress. I was doing a lot of positive things, but I still felt bad.
Currently, I think I would describe Effexor as protecting me from most of the feelings of depression and anxiety, but I would rarely say that I was feeling real good. I don,t know if that is the best I can hope for after 11 years of daily AD use.
Pretty long answer for a one word question.
Regards,
Ray
Posted by ed_uk on January 5, 2006, at 14:27:56
In reply to Re: testing, posted by rfs on January 4, 2006, at 15:26:31
It sounds like Paxil and Effexor were quite similar for you. I also found them similar. I took 40mg Paxil for a few years.
Ed
Posted by rfs on January 5, 2006, at 17:02:29
In reply to Re: testing » rfs, posted by ed_uk on January 5, 2006, at 14:27:56
> It sounds like Paxil and Effexor were quite similar for you. I also found them similar. I took 40mg Paxil for a few years.
>
> EdHi Ed,
Did one or both of these meds,lose some of their effectiveness over time for you, if so have you found any AD or combo that is working well for you. now I am still taking the effexor and bupropion. (9 days bupropion). I have a little more energy and feel more alert.I also find myself a little more assertive or agressive. I try to get the last word in sought of thing. In no way have I felt it was a problem, and maybe at times a plus. Once I told my Pdoc that I was still feeling anxious orstill feeling anxious in some social situations, and he said I could add more effexor. So for a few days I went from 300mg to 350mg. I didnt notice any results so I stopped. He did say that there was only anecdotal evidence that it helped some. I feel as though I have bombarded my serotonin receptors with so much serotonin that they have become desensitized, but I dont know how to change that at this point.
Ray
Posted by ed_uk on January 8, 2006, at 10:04:28
In reply to Re: testing » ed_uk, posted by rfs on January 5, 2006, at 17:02:29
Hi Ray
>Did one or both of these meds,lose some of their effectiveness over time for you
No, but I take citalopram at the moment.
>I feel as though I have bombarded my serotonin receptors with so much serotonin that they have become desensitized, but I dont know how to change that at this point.
The adaptations of serotonin receptors may play a role in the efficacy of SSRIs. In the treatment of some conditions eg. OCD, the efficacy of an SSRI may increase over time.
Ed
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