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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 65. This is the beginning of the thread.
Posted by chess on February 16, 2006, at 14:02:36
other than the benzos, has anyone ever tried Neurontin of Topomax for anxiety?
my doc has proposed klonopin or neurontin
i've never taken neurontin before
anybody know if neurontin works as well or better than klonopin for anxiety?
Posted by krybrahaha78 on February 16, 2006, at 16:06:02
In reply to best med for GAD?, posted by chess on February 16, 2006, at 14:02:36
in my opinion, klonopin works alot better for GAD than Neurontin.
Posted by Emily Elizabeth on February 16, 2006, at 21:16:32
In reply to Re: best med for GAD?, posted by krybrahaha78 on February 16, 2006, at 16:06:02
I've never tried Klon, but I've taken neurontin for a few yrs now. My GAD is complicated by major depression, so taking a benzo regularly wasn't a great option for me. I found neurontin to quiet my mind (i.e., rumination). On the other hand, an SSRI helped me more w/ physical symptoms of anxiety. My pdoc did tell me that most people found the opposite to be true.
Neurontin might be worth a try. It is pretty low on side effects.
I also found that taking a sleep med in order to help me get a good night's sleep helped my anxiety a lot.
Best,
EE
Posted by Phillipa on February 16, 2006, at 21:47:54
In reply to Re: best med for GAD?, posted by Emily Elizabeth on February 16, 2006, at 21:16:32
That is opposite of what most would say. Fondly, Phillipa
Posted by tizza on February 17, 2006, at 1:17:57
In reply to best med for GAD?, posted by chess on February 16, 2006, at 14:02:36
I suffer from GAD and have found over the years that benzo's work the best for me. If you try the klonopin and it's too strong valium is always a good option but I would be vary of xanax or any of the shorter acting benzo's, they have a greater chance of dependence. As for the other 2 options you mentioned I haven't tried them
Posted by Ljoltof on February 17, 2006, at 2:05:34
In reply to Re: best med for GAD? » chess, posted by tizza on February 17, 2006, at 1:17:57
After 8 years of klonopin (for GAD) and having tried all of the common benzo's, I will vote against klonopin here. I have found valium (diazepam) to be most effective for me, as calming and consistant. If your anxiety is 'always-on' (which should be the case for GAD dx) stay away from the short acting benzo's.
Give valium a good try before you turn to klonopin.
Posted by ed_uk on February 17, 2006, at 15:05:54
In reply to Re: best med for GAD?, posted by Ljoltof on February 17, 2006, at 2:05:34
Hi
What do you prefer about Valium compared to Klonopin? What doses do/did you take?
Ed
Posted by Ljoltof on February 17, 2006, at 16:51:56
In reply to Re: best med for GAD? » Ljoltof, posted by ed_uk on February 17, 2006, at 15:05:54
Ed:
Over ~8 years between 1mg-2mg Klonopin divided in two doses (bid) - morning/late-afternoon. The past 4 or 5 years have been 2mg daily though.
I am actually on both Klonopin and Valium currently, but I am slowly and safely subtracting Klonopin by .5mg at 2 or 3 week intervals and inserting an 'equivalent' dose of Valium to compensate. What I'm doing is essentially replacing the Klonopin for Valium while being as gentle as possible to my mind & body.
This schedule and dosing is by my design and my doctor is pleased with my decisions. Charts I found while researching suggested that 20mg Valium is equivalent to 1mg Klonopin.
From past experience with both meds *in my case!* I find 30mg Valium to be equivalent to 1mg Klonopin. I'm a fast metabolizer in general and also take a total of 60mg Adderall daily, certainly worth mentioning.
Why I prefer Valium is because Klonopin at some point brought a rise in my dysphoric/unipolar treatment resistant depression. It has made my depression and mood spike frequently. I've certainly become less sharp cognitively and experienced a now chronic effect of muscle pain and weakness as well as frequent headaches building up from pain in my very upper back. Also, the rarely noted side-effect of one side of the body becoming weaker than the other has hit me hard. I have done extensive physical therapy and had imaging done of my entire body. Imaging results came back with nothing abnormal showing. Valium has never displayed a hint of the above issues and I feel like I really got rested sleep when waking up in the morning. Most importantly - the Valium controls my anxiety at a much more consistent rate and never feels like a 'hard' drug.
**These are strictly my own experiences and I am not in any way attempting to scare people away from Klonopin. Please _never_ attempt to quit any of these meds without support from your doctor! If you read this and are concerned please speak with your doctor about whatever concerns you and go from there.**
> Hi
>
> What do you prefer about Valium compared to Klonopin? What doses do/did you take?
>
> Ed
Posted by Greif on February 17, 2006, at 18:17:38
In reply to best med for GAD?, posted by chess on February 16, 2006, at 14:02:36
I took Nuerontin for 1 year before switching to Clonazapam. Nuerontin made me tired and a bit slow however kept my mood very stable (waht was left of it). I have not needed to up my dosage of K over the 2 MG. Lyrica is the Nuerontins replacement. It is more than a patent attempt (nuerontin expired). Lyrica is much stronger and much more effevtive. I could not handle the strength of 150mg. Switched back to K. If I ever taper off K I will augment it with Lyrica. Might give it a try. It works very well for some. There are threads on this board that tell of its challenges. My Doc is having good luck with it. For me Klonopin works the best. No anxiety and I can barely tell I am on it.
Posted by corafree on February 17, 2006, at 20:29:18
In reply to Re: best med for GAD? » chess, posted by tizza on February 17, 2006, at 1:17:57
I am in the midst of a paradoxical reaction to the Valium I've been on nearly one year. Hope this post gets thru'. cf
Posted by Greif on February 17, 2006, at 21:50:16
In reply to Re: best med for GAD? » tizza, posted by corafree on February 17, 2006, at 20:29:18
Hello Cora...Hope you are well. The old paradoxical reaction (familiar)...on valium yet. Would you care to share what other meds (if any) you are taking and the symptoms.
Posted by Phillipa on February 17, 2006, at 22:41:38
In reply to Re: best med for GAD? » tizza, posted by corafree on February 17, 2006, at 20:29:18
Corafree glad you get through!!!!!Love Phillipa/Jan
Posted by corafree on February 18, 2006, at 12:50:14
In reply to Re: best med for GAD?, posted by Greif on February 17, 2006, at 21:50:16
It's good to be back. It's been a year since started Val 10mg x3 a day, after a nervous breakdown (I've written a description of what 'went down' and saved here on a file.) 3/05.
I just lost a couple things, 10-yr things, a home and a guy. I'm not adjusting well to the move particularly.
As anxiety heightened, Val became less effective and now, well truly think feel less anxious w/o it. No P to monitor a titration, so would/am going it alone. Fed up w/ ADs. But, my sleep med is one unfortunately; trazodone.
Last eve' tho, after some tears and some conversation, I took one Val and no traz, and felt relaxed enough to sleep.
I'd gone thru prob' 5th time on Eff-XR and it seems no ADs are helpful. Tried Trileptal and didn't note any assistance w/ it. Was having some night terrors. Discontinued it.
So I'm pretty much on only the two aforementioned, psych meds, less than ever over a 30yr period.
Hope I've not opened a can of worms here .. I obviously need assistance w/ my anxiety. Prob' is P won't see me.
I'm going to get a glass of juice, and some supplements that seem to be helping, mag citrate .. cal and min . B3 .. an EFA; if staying home, some powdered taurate w/ a herbal tea seems helpful.
I am on a narcotic for back pain, Percocet; that ole' 'another show' story!
I'm 'agoraphobized', have an appt, hard work just getting out the door.
Gotta try .. bestwishes, cf
Posted by ed_uk on February 18, 2006, at 14:11:20
In reply to Re: best med for GAD?, posted by Ljoltof on February 17, 2006, at 16:51:56
Hi
What doses of Val and Klon are you taking at the moment?
Thanks
Ed
Posted by Ljoltof on February 18, 2006, at 18:40:09
In reply to Re: best med for GAD? » Ljoltof, posted by ed_uk on February 18, 2006, at 14:11:20
Ed -
20mg V. and 1.5mg K.
> Hi
>
> What doses of Val and Klon are you taking at the moment?
>
> Thanks
>
> Ed
Posted by Greif on February 19, 2006, at 17:10:24
In reply to Re: best med for GAD?, posted by corafree on February 18, 2006, at 12:50:14
Hello Cora...sorry to hear of your many challenges. Losing a home and relationship combined with pain and anxiety is about as unpleasant as it gets. Most of us have been (or are currently) beeen there. Do you live in the US? Need a good doctor and thrapist or coach/friend to get you back into the swing of things. In hindsight the less busy I was the more I focused on meds to make me feel better. I am not trying to make light of your situation or simplify it. You are living it. You will get through it. You will get many opnions here. Is it possible to take non narcotic pain meds. I only take 500MG Ipubrofin for any pain. Benzo synergystic effects can make you tired depressed and generaly out of it (not always a bad thing). Good luck.
Posted by corafree on February 20, 2006, at 4:22:13
In reply to Re: best med for GAD?, posted by Greif on February 19, 2006, at 17:10:24
Bob was down and I've been 'down' too, so just getting back.
Tks Greif
Unfortunately, narcotics work too well for anxiety. That, and having some extra val so can take 1-1/2 or 2, deviating from my regimen due to unbearable anxiety, is what is getting me through this paradox. I've c-spine and t-spine extruded discs. No meds either than aforementioned, not PT or epidurals, have helped. Surgery for a person w/ chronic pain (someone who didn't just get flown in from a car accident) takes the back seat. Trigger point injections are helpful; doc's hold those back .. maybe 3x a yr.
Pain & Anxiety .. re: Neurontin and Topomax. I've been on both and had 'irritating side effects (more w/ Topomax I think)' so prob' couldn't get to high enough dosage; noted no real relief. Butttttt, was on Prozac or Eff-XR alongside, and so may not have been in touch w/ myself.
I'd like to see read more discussion about Neur and Topo tho', for anxiety (as well as pain), and the new one, 'supposed to be better!' ... Lyrica.
Is Ljoltof here, or anyone interested in to follow:
Did you ever have have paradoxical effect (or is it affect?) w/ Valium? If yes, was it dc'd or increased?
Has anyone had a scrip of 10mg 3x a day increased because anxiety was heightening? Did the increase help, on its own, standing alone from any other benzo, for at least couple yrs?
*** I think someone here is on val and klon? I'm wondering if the klon protects one from a paradoxical reaction to val; like a safety valve to catch anxiety overflow?! ***
I definitely vote benzos best medicinal relief
for anxiety. For me .. Ativan not strong enough .. Xanax quickly here and gone .. Klonopin is a snake in the grass, but became obvious was very effective .. Valium saved my life.Now I'm in 'paradox' and trying to get an idea of a hypothetical med plan that I can present to a P in a way that feels as if I just 'reminded them of an idea they'd not yet brought to the table'. I need to get another P soon, like Tuesday.
Out of space and time .. sooo exhausted. Hope some of above helps one, some, or I, isn't written carelessly. Dropping off ... bw, cf
Posted by ed_uk on February 20, 2006, at 12:25:50
In reply to Re: best med for GAD?, posted by Ljoltof on February 18, 2006, at 18:40:09
Hi
I hope you can get off the K altogether. It sounds like the V is a better med for you :)
Ed
Posted by ed_uk on February 20, 2006, at 12:28:09
In reply to Re: best med for GAD? » Greif, posted by corafree on February 20, 2006, at 4:22:13
Hi cf
Have you ever tried amitriptyline (Elavil) or nortriptyline (Pamelor) for the pain?
Ed
Posted by Ljoltof on February 20, 2006, at 14:06:33
In reply to Re: best med for GAD? » Ljoltof, posted by ed_uk on February 20, 2006, at 12:25:50
Hey, thanks for the kind words and I do believe you are correct about the V being better suited to me. I will be here to report on the experiment/experience!
L.
> Hi
>
> I hope you can get off the K altogether. It sounds like the V is a better med for you :)
>
> Ed
Posted by ed_uk on February 20, 2006, at 14:14:22
In reply to Re: best med for GAD? » ed_uk, posted by Ljoltof on February 20, 2006, at 14:06:33
Please do :)
Ed
Posted by corafree on February 20, 2006, at 14:22:38
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 20, 2006, at 12:28:09
I believe amitriptyline maybe 15-20yrs back for "depression" (hate the word), before accidents. Don't think Pamelor. cf
Posted by ed_uk on February 20, 2006, at 15:31:07
In reply to Re: best med for GAD? » ed_uk, posted by corafree on February 20, 2006, at 14:22:38
Hi Cf
Perhaps you should try it again for your pain.
Ed
Posted by Ljoltof on February 20, 2006, at 22:36:50
In reply to Re: best med for GAD? » Greif, posted by corafree on February 20, 2006, at 4:22:13
Corafree - I have been following your posts on this thread and it hits me hard because I can relate to so much of what you are going through. Here I will inject my thoughts below your quotes.
*these are my ideas / opinions and I am not a healthcare professional of any sort*
>Unfortunately, narcotics work too well for anxiety. That, and >having some extra val so can take 1-1/2 or 2, deviating from >my regimen due to unbearable anxiety, is what is getting me >through this paradox.I agree that narcotics work very well for anxiety. From what I have gathered, a large amount of people with constant/chronic anxiety (aka GAD) also have chronic pain symptoms. Physical pain has been linked to depression and vice versa. I will not ever believe that GAD can exist in a person without depression. It took me a while to face the depression as it's own entity, but looking back and adding it all up leads me to insist that I would not have gotten to the levels of depression I have seen without the GAD causing so much difficulty. Now add in some physical injuries (either before or after GAD/dep. onset) and the chronic pain becomes a major obstacle to everyday life as you very well know.
> I've c-spine and t-spine extruded discs. No meds either than >aforementioned, not PT or epidurals, have helped. Surgery for >a person w/ chronic pain (someone who didn't just get flown in >from a car accident) takes the back seat. Trigger point >injections are helpful; doc's hold those back .. maybe 3x a yr.
Exactly, if an injury isn't a huge event of some sort, that injury is treated as minor - put on the back burner - not followed up on until you call the doctor the point where it looks like you're on a rabid drug hunt. I'm sort of outlining my pain situation here which is delivered via at least 3 head injuries. When these injuries are presented to my gen. physician as the major causes for my chronic back, neck and head pain (numbness in the legs etc etc) there is nothing on file to back these incidents up. That is where it's my fault..in my 2 worst injuries (14yrs old head over handlebars on a bmx bike flying down a hill, entire right side of my face was basically ripped apart, and at 18yrs old victim of a drunken 21yr old jock just out of bootcamp - the tough guy ran up from behind on a side walk punched me across the face knocking me out ..) 1st injury I picked my bike back up after regaining consciousness and somehow rode it back home. I did see my pediatrican a few days later and his first remark is something I'll never forget: "Wow. You are extremely luckily to not have suffered a brain injury." 2nd time I jumped up after being knocked out, for what I'm guessing was about 5secs., and ran towards the guy with blood flowing out of my mouth and nose as my brother was beating the sh1t out of him in the middle of the street - 2 cops grab me just before I get in range to put my boot straight down onto his already bashed in face. Cops ask me if I want the ambulance - everyone I'm with is saying lets get out of here and with my GAD in the picture I could not disagree. Filthy 'marine' got arrested while me and my brother walked away. Most important thing is that both of these injuries involve major force trauma to the head and neck simultaneously.
I have received 0 rx pain pills to this point (mid 20's now) but I have had far too many psychiatric drugs thrown my way to start counting as I write this. Is it just me or is something wrong with that picture?
> Pain & Anxiety .. re: Neurontin and Topomax. I've been on >both and had 'irritating side effects (more w/ Topomax I think)' >so prob' couldn't get to high enough dosage; noted no real >relief. Butttttt, was on Prozac or Eff-XR alongside, and so may >not have been in touch w/ myself.No experience with Neurontin or Topomax. Prozac stole my ability to feel anything at all for almost two years - when I quit it myself. Effexor XR just had me feeling irritated and I got the electricity effect....not a good time.
> I'd like to see read more discussion about Neur and Topo tho', >for anxiety (as well as pain), and the new one, 'supposed to be >better!' ... Lyrica.Lyrica looks to be just the latest cash cow to me. My suggestion for the anxiety and the pain is to add in another 10mg of Valium daily and switch from percocet to an equivalent dose of a slightly different narcotic pain killer?
> Is Ljoltof here, or anyone interested in to follow:
>
> Did you ever have have paradoxical effect (or is it affect?)>w/ .Valium? If yes, was it dc'd or increased?I'm here :) ..and I'll say flat out that I have had a paradoxical effect from Klonopin and every other benzo I've ever tried. I'd wager that effect is the appropriate form in the topic at hand because it is indeed a consequence/result of taking the med. It comes down to how long the effect lasts, the frequency, and the turbulance it causes you. I suspect the narcotic (especially percocet with that very short half life) is aiding in making this harder for you.
> Has anyone had a scrip of 10mg 3x a day increased because >anxiety was heightening? Did the increase help, on its own, >standing alone from any other benzo, for at least couple yrs?I could be taking my 10mg tabs 3x, but I have been only taking 2 a day - as I've been fairly comfortable with my anxiety.
> *** I think someone here is on val and klon? I'm wondering if >the klon protects one from a paradoxical reaction to val; like a >safety valve to catch anxiety overflow?! ***I understand what you're getting at and yes I am on both but it is only as a vehicle to say 'goodbye' to klonopin. Having 2 benzo's going simultaneously is not viewed as a permanent option for me.
> I definitely vote benzos best medicinal relief
> for anxiety. For me .. Ativan not strong enough .. Xanax >quickly here and gone .. Klonopin is a snake in the grass, but >became obvious was very effective .. Valium saved my life.In the short term, or for 'as needed' I'd be voting for benzo's right with you. However, I have found normal doses of narcotic pain pills to be the ultimate GAD/Social Anx. destroyer. Some of the finest days of my life were provided by vicodin, which were rx'd due to an infection in my throat.
> Now I'm in 'paradox' and trying to get an idea of a >hypothetical med plan that I can present to a P in a way that >feels as if I just 'reminded them of an idea they'd not yet >brought to the table'. I need to get another P soon, like >Tuesday.
I'm in a similar situation as my chronic pain gets harder to manage almost every day...I mean should someone who has been taking benzo's and amphetamines for *years* with no substance abuse history and no criminal record really be denied at least a small script of pain pills?
> Out of space and time .. sooo exhausted. Hope some of >above helps one, some, or I, isn't written carelessly. Dropping >off ... bw, cfWell there's my attempt at a decent but not too long of post..haha. Sorry if it's hard to read, I usually do proof-read but I'm spent right now!
All of this is so complicated, but just hold on and reach out...myself and plenty of others are right there with you.
Peace and best wishes for all.
-Ljoltof
Posted by corafree on February 21, 2006, at 4:11:01
In reply to Re: best med for GAD? » corafree, posted by ed_uk on February 20, 2006, at 15:31:07
Ed ... think Elavil or Pamelor? Or does anyone else have experience w/ either? bestwishes, cf
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