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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by UgottaHaveHOPE on May 18, 2006, at 21:34:31
I am absolutely ravaged every day by anxiety. Its like my body is still and my motor (energy) is going 100 miles per hour. It's a overwhelming sense of fear and I don't even know what I fear.
I've tried Klonopin (still taking), Xanax, Buspar, and most of the SSRI's. The only thing that touched it at all in 10 years was Seroquel. Anyone know why? Anyone have any suggestions on what else to try? Thanks Michael
Posted by Phillipa on May 18, 2006, at 21:58:30
In reply to How can I calm down?????, posted by UgottaHaveHOPE on May 18, 2006, at 21:34:31
Just a thought could it be akathesia? Love Phillipa
Posted by UgottaHaveHope on May 18, 2006, at 23:47:58
In reply to How can I calm down?????, posted by UgottaHaveHOPE on May 18, 2006, at 21:34:31
I am absolutely ravaged every day by anxiety. Its like my body is still and my motor (energy) is going 100 miles per hour. It's a overwhelming sense of fear and I don't even know what I fear.
I've tried Klonopin (still taking), Xanax, Buspar, and most of the SSRI's. The only thing that touched it at all in 10 years was Seroquel. Anyone know why? Anyone have any suggestions on what else to try? Thanks Michael
Posted by yxibow on May 19, 2006, at 1:43:43
In reply to YXibow, LarryHoover, Blueberry, Ed, Link, SLS?????, posted by UgottaHaveHope on May 18, 2006, at 23:47:58
> I am absolutely ravaged every day by anxiety. Its like my body is still and my motor (energy) is going 100 miles per hour. It's a overwhelming sense of fear and I don't even know what I fear.
>
> I've tried Klonopin (still taking), Xanax, Buspar, and most of the SSRI's. The only thing that touched it at all in 10 years was Seroquel. Anyone know why? Anyone have any suggestions on what else to try? Thanks Michael
Actually I would hesitate to theorize on all sorts of speculations including that you say you have an internal motor energy which may be dampened by the D2 effects of Seroquel although that is just amateur drawing at straws....Neuroleptics are fairly powerful anxiolytics for certain disorders which for unknown reasons are not solved by other medications. Another posture that is more likely is that the sheer sedation from Seroquel and the 5HT effects are dampening an overactive mind perhaps in the OC Spectrum.
If that is the case you may be helped by a combination of an SSRI and Seroquel (e.g. Luvox+Seroquel, Celexa+Seroquel, etc.)
And one could also venture into the concept that you have a slight bit of psychosis attached to perhaps something more in the manic/bipolar spectrum, but that is getting a bit pejorative and in the realm of "practicing medicine without a licencse." (Well of course all conjecture really is -- we can only give a possibility.)
If we look back at all the medications, the only thing in common is that the SSRIs and the Seroquel both act on serotonin, but they do in a completely different way. SSRIs block the reuptake of serotonin into synapses (I'm simplifying things) while Seroquel forms a blockade of serotonin outright, at among others 5HT2. The only other component is the D2, which is only in the Seroquel, and the huge component of H1 (antihistamine and drowsy effect.) The BuSpar you took is actually a "failed antipsychotic" that is used for anxiolytic relief with about 1/3 of the population reporting some relief.I'm not sure on the doses of Klonopin or Xanax you took -- you might not have had a enough of a dose to counteract whatever is going on inside.
That's the thing here, I think that while better living through chemistry is great -- you obviously identify an anxiolytic disorder, I conjectured a whole variety of possibilities but they're really just pulling rabbits out of a hat -- I think that some psychotherapy and possible psychological testing if your insurance or monetary situation allows you to do these things as they may shed more light on the center of your fear. This doesn't mean you shouldn't continue taking the medication that is helping you along with that process.
Posted by Larry Hoover on May 19, 2006, at 6:20:52
In reply to How can I calm down?????, posted by UgottaHaveHOPE on May 18, 2006, at 21:34:31
> I am absolutely ravaged every day by anxiety. Its like my body is still and my motor (energy) is going 100 miles per hour. It's a overwhelming sense of fear and I don't even know what I fear.
>
> I've tried Klonopin (still taking), Xanax, Buspar, and most of the SSRI's. The only thing that touched it at all in 10 years was Seroquel. Anyone know why? Anyone have any suggestions on what else to try? Thanks MichaelWith such a history, the chronicity alone suggests that medication alone isn't going to work. I apologize for recycling something I posted earlier, to someone else, but I didn't sleep worth a darn last night, and I don't feel like reinventing the wheel this morning.
I am sorry to hear how burdensome this all is. You're ready to do nearly anything, to find relief. But thinking, and treatment decisions, can become disconnected from the biochemical process which seems to have been disturbed. The underlying dysfunction could be treatable in other realms than pharmacology. The physical environment occupied by receptors influences receptor conformation as much as do ligands, agents which bind at the receptor complex. Yet medical attention tends to focus on agonism or antagonism, rather than in augmentation of the natural brain environment.
Prolonged stress, such as your anxiety state, can cause the body to maladapt. As one example, magnesium ions are essential for the GABA-A receptors to be in the receptive conformation that then is activated by some agonist molecule. Attempts to agonize the receptor, without sufficient magnesium, simply fail. The self-perpetuating characteristic of this scenario is that stress hormones cause the kidneys to become less efficient at retaining magnesium ions. Repeated or chronic stressors cause depletion of magnesium from all tissues, and a viscious circle results. When common anxiolytics fail, or provide only weak response, then it makes sense to see if the biochemical machinery is properly supplied with essential nutrients. {Addendum: over 90% of Americans have diets deficient in magnesium to begin with.}
Another self-perpetuating anxiety loop can develop in the trans-sulphuration pathway that forms a variety of essential molecules from the amino acid methionine. The end result is a deficiency in taurine, one of the most powerful neuromodulators. I don't know why taurine doesn't get more attention; there are dedicated reuptake pumps for taurine in every synapse yet examined (I'm pretty sure). Taurine readily crosses the blood/brain barrier (unlike GABA), and it has similar effect, completely antagonizing glutamate excitation.
Also, the amide of nicotinic acid (B3), called variously niacinamide or nicotinamide, is both a conformational promoter at the GABA-A receptor, but it also mildly agonizes that same receptor.
These ideas directly address fully supporting innate receptor function. The "defect" may not be in agonism/antagonism, at all.
Food for thought. Back after babblefest.....
Lar
Posted by SLS on May 19, 2006, at 10:22:41
In reply to How can I calm down?????, posted by UgottaHaveHOPE on May 18, 2006, at 21:34:31
> I am absolutely ravaged every day by anxiety. Its like my body is still and my motor (energy) is going 100 miles per hour. It's a overwhelming sense of fear and I don't even know what I fear.
>
> I've tried Klonopin (still taking), Xanax, Buspar, and most of the SSRI's. The only thing that touched it at all in 10 years was Seroquel. Anyone know why? Anyone have any suggestions on what else to try? Thanks Michael
It sounds like some psychotherapy would be helpful in the long run. However, it might be necessary to think in terms of the short run at this point in time. If your anxiety is not addressed biologically, it will be most difficult to get anywhere in psychotherapy. My suggestion would be to look at Nardil 60-75mg and give it a trial of at least 6 weeks in combination with Klonopin and/or Seroquel. You might even consider going with the Emsam patch. People here are reporting success with using it to ameliorate the anxiety component of their illnesses such that they have been able to reduce their dosages of Klonopin.The taurine does sound interesting.
How does alcohol affect you?
Have you ever considered the possiblity that you might be bipolar? Perhaps anxiolytic mood stabilizers like Depakote would be helpful.
I think it will be important for you to isolate the situational factors that act as triggers for your anxiety or manic episodes.
- Scott
Posted by madkat02 on May 19, 2006, at 11:37:18
In reply to Re: YXibow, LarryHoover, Blueberry, Ed, Link, SLS? » UgottaHaveHope, posted by yxibow on May 19, 2006, at 1:43:43
> > I am absolutely ravaged every day by anxiety. Its like my body is still and my motor (energy) is going 100 miles per hour. It's a overwhelming sense of fear and I don't even know what I fear.
> >
> > I've tried Klonopin (still taking), Xanax, Buspar, and most of the SSRI's. The only thing that touched it at all in 10 years was Seroquel. Anyone know why? Anyone have any suggestions on what else to try? Thanks Michael
>
>
> Actually I would hesitate to theorize on all sorts of speculations including that you say you have an internal motor energy which may be dampened by the D2 effects of Seroquel although that is just amateur drawing at straws....
>
> Neuroleptics are fairly powerful anxiolytics for certain disorders which for unknown reasons are not solved by other medications. Another posture that is more likely is that the sheer sedation from Seroquel and the 5HT effects are dampening an overactive mind perhaps in the OC Spectrum.
>
> If that is the case you may be helped by a combination of an SSRI and Seroquel (e.g. Luvox+Seroquel, Celexa+Seroquel, etc.)
>
> And one could also venture into the concept that you have a slight bit of psychosis attached to perhaps something more in the manic/bipolar spectrum, but that is getting a bit pejorative and in the realm of "practicing medicine without a licencse." (Well of course all conjecture really is -- we can only give a possibility.)
>
>
> If we look back at all the medications, the only thing in common is that the SSRIs and the Seroquel both act on serotonin, but they do in a completely different way. SSRIs block the reuptake of serotonin into synapses (I'm simplifying things) while Seroquel forms a blockade of serotonin outright, at among others 5HT2. The only other component is the D2, which is only in the Seroquel, and the huge component of H1 (antihistamine and drowsy effect.) The BuSpar you took is actually a "failed antipsychotic" that is used for anxiolytic relief with about 1/3 of the population reporting some relief.
>
> I'm not sure on the doses of Klonopin or Xanax you took -- you might not have had a enough of a dose to counteract whatever is going on inside.
>
> That's the thing here, I think that while better living through chemistry is great -- you obviously identify an anxiolytic disorder, I conjectured a whole variety of possibilities but they're really just pulling rabbits out of a hat -- I think that some psychotherapy and possible psychological testing if your insurance or monetary situation allows you to do these things as they may shed more light on the center of your fear. This doesn't mean you shouldn't continue taking the medication that is helping you along with that process.Hi I have one thing to say, even though I don't completely understand all that has been stated above. I experienced EXTREME anxiety and fear when I was on Xanax. When I finally saw a Psychiatrist instead of a regular M.D., she told me that Xanax causes rebound anxiety in most people and she personally never prescribes it. In addition to this my psycologist insist that it is also very bad. She has known several people to die from Xanax and alcohol combonation. Maybe talk to your doctor about this being a possibility of not being able to calm down. It feels as if you are about to crawl out of your skin, I know hang in there.
Posted by UgottaHaveHOPE on May 19, 2006, at 13:11:56
In reply to Re: How can I calm down?????, posted by SLS on May 19, 2006, at 10:22:41
Alcohol most definitely relaxes me. Does that mean anything?
My grandmother was BP. The pdocs I have seen so far say that I might have some symptoms of BP2.
SLS, I have grown so used to this anxiety that it feels weird when I dont have it. The abnormal feels like the normal, and vice versa. Does that make any sense?
Again, the only thing that has ever really touched this anxiety is Seroquel. And it took a few months before I could accept that I was feeling better. That's the type of grip this thing has on me. (At the beginning of April, I got upset over a financial transaction, and have been reeling ever since).
I guess meds are the short-term answer, and therapy is the long-term answer. However, it is difficult to comprehend any therapy when my anxiety level is so high.
Any thoughts from anyone? I really appreciate anybody's input. Please speak in laymen's terms. Thanks, Michael
Posted by blueberry on May 19, 2006, at 16:04:43
In reply to YXibow, LarryHoover, Blueberry, Ed, Link, SLS?????, posted by UgottaHaveHope on May 18, 2006, at 23:47:58
I like the suggestion of taurine. It is real cheap, natural, and right at your local drug store or health food store. It is amazingly calming and actually healthy.
From my own experience, I find it hard to tell the difference between antipsychotic or ssri induced akathisia versus anxiety. Both are aweful. Especially the fear part. That is one of my main problems right now. What you are feeling could actually be a side effect of a higher dose of seroquel.
I have noticed that norepinephrine enhancing meds (seroquel is one) intensify my fear. When you were at lower doses it probably wasn't doing that very much.
While you are waiting to see a doctor, go buy some taurine right now. Try 500mg. If nothing in 2 hours, try another 500mg. Usually people take about 1000mg to 1500mg a day, but some people here have reported taking 3000mg to 6000mg on a daily basis. Our diets don't usually provide enough of it, and a lot of times our bodies don't produce enough of it.
You could try a higher dose of seroquel just for a couple days and see what happens. If things get worse, you'll know it's the seroquel.
Posted by UgottaHaveHOPE on May 19, 2006, at 19:34:23
In reply to Re: YXibow, LarryHoover, Blueberry, Ed, Link, SLS? » UgottaHaveHope, posted by blueberry on May 19, 2006, at 16:04:43
Seroquel calms me at all levels, or makes me sort of space out, which is good. What is Taurine? Can you take it with meds? What are your experiences on it?
Posted by Phillipa on May 19, 2006, at 19:47:16
In reply to Re: YXibow, LarryHoover, Blueberry, Ed, Link, SLS?, posted by madkat02 on May 19, 2006, at 11:37:18
I drank 4-6 beers nightly on xanax and it only made me feel better and I could work them. So unless you are taking really high doses of xanax and drinking bottles of alcohol I never saw anyone even get sick. Love Phillipa
Posted by Dr. Bob on May 21, 2006, at 15:39:20
In reply to Blueberry ... What is Taurine??, posted by UgottaHaveHOPE on May 19, 2006, at 19:34:23
> What is Taurine?
Sorry to interrupt, but I'd like to redirect follow-ups regarding Taurine to Psycho-Babble Alternative. Here's a link:
http://www.dr-bob.org/babble/alter/20060428/msgs/646593.html
Thanks,
Bob
This is the end of the thread.
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