![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 36. This is the beginning of the thread.
Posted by FredPotter on December 4, 2006, at 22:52:27
When I think back over all the drugs I've been prescribed, benzos are the only ones that I could swear do anything, esp Xanax. And sleepers perhaps. But these are the very ones many Drs want us to stop.
I take Effexor 225mg and Wellbutrin 150mg at the moment. They don't do anything good. W gives me weak legs in the evening and if I up the dose to 300mg I feel scared. Enter Xanax once more. I don't know if any of you suffer tinnitus, but I find W makes it worse
Fred
Posted by Quintal on December 4, 2006, at 23:20:17
In reply to Are benzos the only drugs that do anything?, posted by FredPotter on December 4, 2006, at 22:52:27
No, I don't think they're the only drugs that actually work - amphetamines also have powerful effects for example. I know what you mean about the ADs though, after a brief high they always seemed to poop out on me or just made me generally ill and sexually defunct.
Q
Posted by med_empowered on December 5, 2006, at 0:52:38
In reply to Re: Are benzos the only drugs that do anything? » FredPotter, posted by Quintal on December 4, 2006, at 23:20:17
Antidepressants are lame. They sometimes don't even do better than placebo in controlled trials. They cause side effects. Overall...they suck.
If a benzo does the trick for you, and you're not: a) snorting it b) injecting it c) overusing it d) selling it or e) using it to escape issues that need to be dealt with, then I say go for it. This whole "benzos=addiction" thing is way overblown, largely by shrinks eager to sell people on new, expen$ive "miracle cures" that, on closer inspection, really aren't all that impressive at all.
People tend to think of benzos are "mommy's little helpers," and they were but..they're very safe, very useful drugs. They also happen to be incredibly cheap, which I think is one reason drug companies are whispering "addiction" and "dependence" into doc's ears; if a $20/month bottle of (xanax, valium, ativan, whatever) works *better* than a 100-500+ bottle of (lamictal, abilify, effexor, whatever) and the patient even *likes* the cheaper one more, where is the profit for big pharma? No where. Of course, you can't really do without benzos in psychiatry--in fact, a lot of times you need them to counter the problems created by the new expen$ive drugs, like anti-depressant induced agitation or neuroleptic-induced akathisia. That said...only the newer drugs are allowed to be called "treatment". These newer, unpleasant, expen$ive, largely ineffective "treatments" are now the real helpers, the restorers of sanity and stability; the benzos, on the other hand, are "quick fixes," "band-aid" solutions, and best used "briefly", if at all. Its ridiculous.Note also how the same profession that has come to demonize or at least disregard the benzos continues to lavish praise on the amphetamines, which are even older, more addictive, and more problematic. Amphetamines are a valid "treatment" for ADHD. ADHD, of course, became quite popular once Adderall and various forms of Ritalin hit the scene; the money pumped into drug development, advertising, and "consumer education" is astounding.
So now, as consumers, this is the situation one finds: if you're an adult who can't leave your house b/c of severe panic attacks, your doc may well withhold potentially helpful benzos...these are "addictive" and best avoided, even if "better" solutions fail. But..if little Timmy can't still still and irritates his teachers and/or parents, he can be quickly "treated" with schedule II meds, the same meds that will land someone found possessing them w/o an RX several years in prison.
Posted by Declan on December 5, 2006, at 5:14:08
In reply to Re: Are benzos the only drugs that do anything?, posted by med_empowered on December 5, 2006, at 0:52:38
'Antidepressants are lame. They sometimes don't even do better than placebo in controlled trials. They cause side effects. Overall...they suck.'
Hey med, that was fun. Tianeptine's been good for me, and I'm very glad my experience with ADs is as limited as it is.IMO the only drugs that do anything much are the ones you can't easily get and probably shouldn't take.
Posted by snapper on December 5, 2006, at 5:17:13
In reply to Re: Are benzos the only drugs that do anything?, posted by med_empowered on December 5, 2006, at 0:52:38
> Antidepressants are lame. They sometimes don't even do better than placebo in controlled trials. They cause side effects. Overall...they suck.
>
> If a benzo does the trick for you, and you're not: a) snorting it b) injecting it c) overusing it d) selling it or e) using it to escape issues that need to be dealt with, then I say go for it. This whole "benzos=addiction" thing is way overblown, largely by shrinks eager to sell people on new, expen$ive "miracle cures" that, on closer inspection, really aren't all that impressive at all.
> People tend to think of benzos are "mommy's little helpers," and they were but..they're very safe, very useful drugs. They also happen to be incredibly cheap, which I think is one reason drug companies are whispering "addiction" and "dependence" into doc's ears; if a $20/month bottle of (xanax, valium, ativan, whatever) works *better* than a 100-500+ bottle of (lamictal, abilify, effexor, whatever) and the patient even *likes* the cheaper one more, where is the profit for big pharma? No where. Of course, you can't really do without benzos in psychiatry--in fact, a lot of times you need them to counter the problems created by the new expen$ive drugs, like anti-depressant induced agitation or neuroleptic-induced akathisia. That said...only the newer drugs are allowed to be called "treatment". These newer, unpleasant, expen$ive, largely ineffective "treatments" are now the real helpers, the restorers of sanity and stability; the benzos, on the other hand, are "quick fixes," "band-aid" solutions, and best used "briefly", if at all. Its ridiculous.
>
> Note also how the same profession that has come to demonize or at least disregard the benzos continues to lavish praise on the amphetamines, which are even older, more addictive, and more problematic. Amphetamines are a valid "treatment" for ADHD. ADHD, of course, became quite popular once Adderall and various forms of Ritalin hit the scene; the money pumped into drug development, advertising, and "consumer education" is astounding.
> So now, as consumers, this is the situation one finds: if you're an adult who can't leave your house b/c of severe panic attacks, your doc may well withhold potentially helpful benzos...these are "addictive" and best avoided, even if "better" solutions fail. But..if little Timmy can't still still and irritates his teachers and/or parents, he can be quickly "treated" with schedule II meds, the same meds that will land someone found possessing them w/o an RX several years in prison.
>
>exactly ......sad but true.
Posted by Phillipa on December 5, 2006, at 11:05:10
In reply to Re: Are benzos the only drugs that do anything? » med_empowered, posted by snapper on December 5, 2006, at 5:17:13
And what happens when you build tolerance to benzos? Take another med or up the dose the later my doc won't do. Love Phillipa ps percocet seemed to make me feel better at lpill per day but doc said they're addictive.
Posted by Quintal on December 5, 2006, at 13:16:39
In reply to Re: Are benzos the only drugs that do anything?, posted by Phillipa on December 5, 2006, at 11:05:10
>And what happens when you build tolerance to benzos? Take another med or up the dose the later my doc won't do.
Yes, you can up the dose of your benzos if your pdoc will let you, but the anti-anxiety effect tends to fade away again just as it did in the first place as your brain builds up tolerance to the higher dose. The higher the dose of benzos you take the more unwanted sedation and depression you are likely to suffer with less benefit on anxiety over time.
It is possible to reset your tolerance level by withdrawing from benzos for a while or temporarily lowering the dose while adding another drug that has anti-anxiety effects to cover you in the period.
>ps percocet seemed to make me feel better at lpill per day but doc said they're addictive.
Have you considered buprenorphine then? It is an opiate like percocet but is supposed to have less abuse potential.
Q
Posted by FredPotter on December 5, 2006, at 14:20:26
In reply to Re: Are benzos the only drugs that do anything? » Phillipa, posted by Quintal on December 5, 2006, at 13:16:39
Dr Shipko of the Panic Research Institute (a garden shed somewhere in Pasadena?) says the tolerance refers to side effects, and anxiolytic effects do not fade. That's not what I find. But yes it's easy to get those effects back by tapering off for a bit.
One good thing about coming off Xanax that I've found is the acutely real visualisation abilities I get, which Xanax seems to blunt
I have to admit the feeling when an SSRI kicks in is the BEST. I feel like a jigsaw puzzle that's been put back together, so smooth and cool. But it doesn't last. My best response was to Paxil, but it lasted one afternoon, after a 6 week wait
Fred
Posted by blueberry on December 5, 2006, at 16:44:06
In reply to Are benzos the only drugs that do anything?, posted by FredPotter on December 4, 2006, at 22:52:27
I had a thread on benzos not too long ago. I've watched other threads on benzos over time. There are actually a lot of people who find a dose that keeps working and they no longer build tolerance.
Talk about withdrawals. Benzo withdrawals are lame compared to something like zyprexa. If doctors are concerned about being dependent on a medication, then they should never prescribe antipsychotics.
Posted by Declan on December 5, 2006, at 17:25:08
In reply to Re: Are benzos the only drugs that do anything?, posted by Phillipa on December 5, 2006, at 11:05:10
In civilised cultures old poeple have the option of maintenance low dose opiates.
Posted by Phillipa on December 5, 2006, at 18:43:21
In reply to Re: Are benzos the only drugs that do anything? » Phillipa, posted by Quintal on December 5, 2006, at 13:16:39
Yes can you tell me anything about it other than it's used for opiod withdrawal. What's it's side effect profile? I doubt my doc will prescribe this either. Seems they all like the atypical antipsychotics.Love Phillipa
Posted by Phillipa on December 5, 2006, at 18:46:18
In reply to Re: Are benzos the only drugs that do anything?, posted by FredPotter on December 5, 2006, at 14:20:26
Fred seriously? One day? Then what happened? How did you get one to work? Love Phillipa
Posted by Phillipa on December 5, 2006, at 18:48:32
In reply to Re: Are benzos the only drugs that do anything? » Phillipa, posted by Declan on December 5, 2006, at 17:25:08
Declan got room for me? Love Phillipa
Posted by Quintal on December 5, 2006, at 18:52:50
In reply to Re: Are benzos the only drugs that do anything?, posted by blueberry on December 5, 2006, at 16:44:06
I've withdrawn from both conventional benzos and Zyprexa and I've found benzos were the worst, though I hadn't been taking Zyprexa for long.
Zyprexa does have a benzodiazepine-like structure but obviously has a different pharmacological profile to other benzos.
There's someone on this site who claims to be a pdoc looking for Zyprexa withdrawal experiences:
http://www.sixthseal.com/2005/01/zyprexa_olanzapine_experience.htmlQ
Posted by Quintal on December 5, 2006, at 18:59:02
In reply to Re: Are benzos the only drugs that do anything? » Quintal, posted by Phillipa on December 5, 2006, at 18:43:21
There's some info on side effects here: http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a605002.html
I doubt many pdocs would be willing to prescribe it either except under special circumstances.
Q
Posted by yxibow on December 6, 2006, at 1:16:18
In reply to Re: Are benzos the only drugs that do anything? » Phillipa, posted by Quintal on December 5, 2006, at 18:59:02
> There's some info on side effects here: http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a605002.html
>
> I doubt many pdocs would be willing to prescribe it either except under special circumstances.
>
> QWhich I have said before -- but not because of the side effects so much -- protease inhibitors are a real sticky wicket to manage with concomitant depression. They would like to keep their DEA license which allows them to prescribe, pay their malpractice insurance in case someone overdoses on buprenorphine, and generally stay out of the limelight of license auditing of doctors who freely prescribe opiates which while they in the short term help those who have been through a number of medications, are not a part of generalized western psychopharmocological practice.
And also while we are on the subject of ranting that no drug on the market does anything, I have to say that, with no disrespect to individuals on this board, who have been through tireless trials of medications, we are a special population. This is why we are here. This is why people rant about medications because a number of them are treatment refractory.A certain unnamed individual who treats me has remarked that even those with MDD in his practice has largely seen that about 70% of patients respond with the first medication. Those are the millions of people who are not this board.
Thus, this board serves a subset of the community who do not respond to one, but maybe need two or more medications to exist.
And then we get into generalized discussions that all medications are worthless. Which by the way is not generally how things are supposed to be phrased on this board. Because there are people who are taking this "worthless" medication X and are responding to it, for better or worse. Even the placebo effect has responders up to 30% of the time.This is a disclaimer that this reflects my opinion and is not a generalized antisocial reflection upon the members of this community. We all in a way help each other by reporting what is known in the medical community as "case reports." Enough of these reports and one might get a feeling for what a medication might do to them -- but one has to remember that everyone is genetically and environmentally different.
--tidings
Jay
Posted by Declan on December 6, 2006, at 2:03:35
In reply to Re: Are benzos the only drugs that do anything? » Phillipa, posted by Declan on December 5, 2006, at 17:25:08
Oh yes, PJ, there's room.
I'd tuck depressives into bed and give them a shot of Dilaudid and read them 'The Tale of Tom Kitten'.
How's that for an irresponsible treatment recommendation?
Posted by Declan on December 6, 2006, at 2:08:23
In reply to Re: Are benzos the only drugs that do anything?, posted by Declan on December 6, 2006, at 2:03:35
Posted by Quintal on December 6, 2006, at 9:34:11
In reply to Re: Are benzos the only drugs that do anything? » Quintal, posted by yxibow on December 6, 2006, at 1:16:18
> Which I have said before -- but not because of the side effects so much -- protease inhibitors are a real sticky wicket to manage with concomitant depression. They would like to keep their DEA license which allows them to prescribe, pay their malpractice insurance in case someone overdoses on buprenorphine, and generally stay out of the limelight of license auditing of doctors who freely prescribe opiates which while they in the short term help those who have been through a number of medications, are not a part of generalized western psychopharmacological practice.
There was no suggestion on my part they would refuse to prescribe buprenorphine on grounds of side effects. It is the legal status and social stigma attached to opiates that I suspect would deter many pdocs from even thinking about prescribing them.
>Thus, this board serves a subset of the community who do not respond to one, but maybe need two or more medications to exist.
Well I've certainly responded to many treatments Jay. The problem has generally been lack of long term efficiency with most drugs besides benzos. It is a very common problem and not only to the people posting on this board. For example, I know of several people that live nearby who have had similar experiences to me. They don't post on websites because they have no access to computers and are not computer literate in any case. Most are middle aged or elderly and living alone.
They also have no access to the detailed information we discuss here and no interest in pursuing it. They're working alone in the dark and have no confidence to challenge their GP/pdoc and request alternative meds and treatments unlike most of the people here. In general they trust the medical profession to give them the best treatment and if the almighty Mr.pdoc says this drug works and they suspect it isn't helping them, then they tend to blame themselves - who are they to argue with medical science?
There's an old lady that lives a few doors down my street who has been on Prozac 20mg for about 10 years since her husband died. She admits it stopped working soon after she started taking it but is now afraid of talking to her GP about it after being chastised by a locum for requesting another medication. The locum made her feel guilty that she was taking medication at all and from that point she decided to try and make the best of whatever positive effects it still had.
She would no doubt be classified as a Prozac responder if her GP was required to produce a report on the efficiency of antidepressants in her patients (as I was bizarrely according to my medical notes, although I felt much worse for having taken it myself).
I think it is reasonable to assume there are many more people in a similar position all over the world who are being marked up as treatment responders simply because they are compliant and tell the GP/pdoc mostly what they want to hear.
>And also while we are on the subject of ranting that no drug on the market does anything, I have to say that, with no disrespect to individuals on this board, who have been through tireless trials of medications, we are a special population. This is why we are here. This is why people rant about medications because a number of them are treatment refractory.
I don't think we're ranting that no medication on the market works, rather that there are some very effective drugs even for people who are refractory to first line SSRIs, but access to them seems excessively restricted - as in the case of benzos and stimulants in the UK.
There are people posting on this board who are doing very well on their drug regimen, sometimes even on a single medication and have come to tell us the good news. I'm encouraged by their results, so I don't think were necessarily a subset of treatment resistant patients here on psychobabble.
Q
Posted by Bob on December 6, 2006, at 13:26:42
In reply to Re: Are benzos the only drugs that do anything? » yxibow, posted by Quintal on December 6, 2006, at 9:34:11
>
> Well I've certainly responded to many treatments Jay. The problem has generally been lack of long term efficiency with most drugs besides benzos. It is a very common problem and not only to the people posting on this board. For example, I know of several people that live nearby who have had similar experiences to me. They don't post on websites because they have no access to computers and are not computer literate in any case. Most are middle aged or elderly and living alone.
>
> They also have no access to the detailed information we discuss here and no interest in pursuing it. They're working alone in the dark and have no confidence to challenge their GP/pdoc and request alternative meds and treatments unlike most of the people here. In general they trust the medical profession to give them the best treatment and if the almighty Mr.pdoc says this drug works and they suspect it isn't helping them, then they tend to blame themselves - who are they to argue with medical science?
>
> There's an old lady that lives a few doors down my street who has been on Prozac 20mg for about 10 years since her husband died. She admits it stopped working soon after she started taking it but is now afraid of talking to her GP about it after being chastised by a locum for requesting another medication. The locum made her feel guilty that she was taking medication at all and from that point she decided to try and make the best of whatever positive effects it still had.
>
> She would no doubt be classified as a Prozac responder if her GP was required to produce a report on the efficiency of antidepressants in her patients (as I was bizarrely according to my medical notes, although I felt much worse for having taken it myself).
>
> I think it is reasonable to assume there are many more people in a similar position all over the world who are being marked up as treatment responders simply because they are compliant and tell the GP/pdoc mostly what they want to hear.
>
That is a very, germane and insightful post. I too sincerely believe there are countless numbers of people suffering while on meds, but remaining silent. There are many who are not computer savvy, or who do not have the energy and motivation to tell the world about what they're feeling. Yes, this is a select group of people with problems on this message board, but I honestly feel it represents the tip of an enormous iceberg of people behind the scenes.A good example would be my sister, who has suffered from depression, anger, and anxiety over the years. She went through a great deal of problems, with the worst times often being coming on and off meds. Then she finally had to go off. She's not working right now, but she doesn't seem to want to go back on them. In the long term, they often caused her serious problems.
As for me, I've tried well over 35 different med combos, with worse and worse results in the past 15 years or so. I can't believe the situation I'm in now, with not only a mental illness, but a litany of serious physical limitations. When healthy, I'm inclined to use computers and analyze my situation and treatment, but most people are probably not.
I was watching a TV show a few nights ago titled something like "I Should be Dead". It showcases little vignettes of people who got themselves into situations from which they miraculously escaped. In this particular case a couple had gone on a hike in the Amazon and got lost. Turns out the woman had been taking an SSRI (which one they didn't bother to reveal) and after about two days become physically ill and unusually suicidal. This is where the show disturbed me. They put forth the laymans' explanation about how someone who is depressed doesn't have enough serotonin and the drugs replace that serotonin. The over simplification was irritating enough to me but I'm used to that one by now. The scary thing was the realization of how withdrawal from a psycotropic is not only not understood, but there's basically no awareness of it in the general population. It was obvious to me that the girl had started to go through a withdrawal, but the show portrayed it has her depression acting up. IMO, it was possibly more of the former, than latter. Anyway, my ultimate point is that the public perception of these diseases as anything more than sadness which can be remedied with a "serotinin pill" that takes it way like aspirin with a headache is very deeply entrenched. Also, the meds I feel, are viewed as quite benign, being very easy to take and discontinue.
One other disturbing media encounter was from listening to news radio the other day. They had a mental health professional interview, to increase awareness I suppose, which is admirable. One statement she made irked me somewhat though: "we have very effective treatments for all these diagnosable diseases". I was quite surprised to hear that. On the one hand you don't want to scare people away from seeking treatment, but on the other, how are we ever going to recognize severe inadequacies in our current treatments?
Posted by FredPotter on December 6, 2006, at 13:58:39
In reply to Re: Are benzos the only drugs that do anything? » Quintal, posted by yxibow on December 6, 2006, at 1:16:18
you're absolutely right yxibow. I guess it's just my frustration coming out. Sorry if anybody believed my post Fred
Posted by Quintal on December 6, 2006, at 14:28:50
In reply to Re: Are benzos the only drugs that do anything? » Quintal, posted by Bob on December 6, 2006, at 13:26:42
> I was watching a TV show a few nights ago titled something like "I Should be Dead". It showcases little vignettes of people who got themselves into situations from which they miraculously escaped. In this particular case a couple had gone on a hike in the Amazon and got lost. Turns out the woman had been taking an SSRI (which one they didn't bother to reveal) and after about two days become physically ill and unusually suicidal. This is where the show disturbed me. They put forth the laymans' explanation about how someone who is depressed doesn't have enough serotonin and the drugs replace that serotonin. The over simplification was irritating enough to me but I'm used to that one by now. The scary thing was the realization of how withdrawal from a psycotropic is not only not understood, but there's basically no awareness of it in the general population. It was obvious to me that the girl had started to go through a withdrawal, but the show portrayed it has her depression acting up. IMO, it was possibly more of the former, than latter. Anyway, my ultimate point is that the public perception of these diseases as anything more than sadness which can be remedied with a "serotinin pill" that takes it way like aspirin with a headache is very deeply entrenched. Also, the meds I feel, are viewed as quite benign, being very easy to take and discontinue.
That's something that always worried me about being on meds - what would happen if I was in a plane crash or something and stranded out in the wilderness, trying to survive at the same time as suffering benzo withdrawal? Or even worse, being stranded, having to live off the land and still follow the MAOI diet for 14 days..................
Q
Posted by zmg on December 6, 2006, at 16:23:49
In reply to Re: Are benzos the only drugs that do anything? » Quintal, posted by Bob on December 6, 2006, at 13:26:42
>On the one hand you don't want to scare people away from seeking treatment, but on the other, how are we ever going to recognize severe inadequacies in our current treatments?
Ignorance is bliss. Thats what I love about this site and sites like it: subjective, experience-based information. Reading reports of doctors being surprised by cessation problems with drugs like Effexor really alarmed me. The information printed on the label isn't a very good place to stop.
Posted by Bob on December 6, 2006, at 16:31:57
In reply to Sudden Med Deprivation » Bob, posted by Quintal on December 6, 2006, at 14:28:50
>
> That's something that always worried me about being on meds - what would happen if I was in a plane crash or something and stranded out in the wilderness, trying to survive at the same time as suffering benzo withdrawal? Or even worse, being stranded, having to live off the land and still follow the MAOI diet for 14 days..................
>
> QThat has crossed my worried mind many times. It's why if I travel, I always take two separate med containers of each drug with me, and keep them in two separate bags (one being a carry on). That way, if something happens to one, at least I have a chance with the other. Of course, more cautious people recommend carrying a prescription for each med you take so you can take it to the pharmacy if need be.
Posted by Bob on December 6, 2006, at 16:33:34
In reply to Re: Are benzos the only drugs that do anything? » Bob, posted by zmg on December 6, 2006, at 16:23:49
> Ignorance is bliss. Thats what I love about this site and sites like it: subjective, experience-based information. Reading reports of doctors being surprised by cessation problems with drugs like Effexor really alarmed me. The information printed on the label isn't a very good place to stop.I get irritated almost every time I see an article in the press, or a show on TV. It almost always demonstrates how little the public knows.
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