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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by cgd092 on January 4, 2007, at 13:48:02
Okay, with my meds, I don't have lack of appetite now, nor early morning wakening, I sleep well, wake rested. But, I still feel this one symptom: I call it "pani-sad." It's panic (anxiety) mixed at the exact same time with sad (depression). Does anyone else have this feeling? What medicine would take care of it: an antidepressant or an anxiolytic? I already take both. It comes out of nowhere (I don't have anything anxious nor depressing in my life.) It hangs around all day. Can I dare wish that meds will knock this feeling out? Or should I be glad I'm helped at all by meds? Pani-sad. I hate it!
Thanks!
-Katy
Posted by blueberry1 on January 4, 2007, at 14:18:33
In reply to I call it, 'Pani-sad.' :), posted by cgd092 on January 4, 2007, at 13:48:02
What medications are you taking? What are the doses? What other meds have you tried?
> Okay, with my meds, I don't have lack of appetite now, nor early morning wakening, I sleep well, wake rested. But, I still feel this one symptom: I call it "pani-sad." It's panic (anxiety) mixed at the exact same time with sad (depression). Does anyone else have this feeling? What medicine would take care of it: an antidepressant or an anxiolytic? I already take both. It comes out of nowhere (I don't have anything anxious nor depressing in my life.) It hangs around all day. Can I dare wish that meds will knock this feeling out? Or should I be glad I'm helped at all by meds? Pani-sad. I hate it!
>
> Thanks!
>
> -Katy
>
>
Posted by cgd092 on January 4, 2007, at 14:43:56
In reply to Re: I call it, 'Pani-sad.' :) » cgd092, posted by blueberry1 on January 4, 2007, at 14:18:33
blueberry1 wrote, "What medications are you taking? What are the doses? What other meds have you tried?"
Oh, sorry I forgot to include that info. Currently I'm on 40mg. Celexa, 100mg. Seroquel (divided dose), and just started a Lamictal trial. The Celexa alone at 20mg. kept bad depression/anxiety at bay for about 20 months, but then seemed to poop out. Going up to even 60mg. didn't help kick the depression/anxiety all the way out. In the past I've been on Zoloft and Prozac for awhile, then Serzone helped for a year or so. I always have Lorazepam around; been taking about .5mg/day. I think I tried Buspar once but not very long for some reason; my Pdoc likes to change things fast it seems.Thanks!
-Katy
Posted by Phillipa on January 4, 2007, at 21:53:07
In reply to Re: I call it, 'Pani-sad.' :), posted by cgd092 on January 4, 2007, at 14:43:56
How fast as a trial is at least 6-8 weeks unless unbearable side effects. And yes I experience something similar. Love Phillipa
Posted by blueberry1 on January 5, 2007, at 23:41:31
In reply to Re: I call it, 'Pani-sad.' :), posted by cgd092 on January 4, 2007, at 14:43:56
Pani-sad. Good work, horrible way to feel. I'm so sorry for that. I wish more people would show up with some suggestions.
I have some ideas but as you know this is a lot like throwing darts. I won't go into long explanations of my reasoning, but...
Xanax instead of lorazepam? But before that, try doubling the dose of lorazepam for 3 days to see if...it helps anxiety...if it worsens depression, helps it, or no difference. That way you'll know more about what it does for you. Xanax is usually better for panic and depression.
Paxil. When hundreds of general practioners were surveyed to find out what they thought were the best ssri's in terms of efficacy for anxiety and depression, paxil was at the top of the list. Other options are effexor (hard to get on and hard to get off), or lexapro (different enough from celexa that people notice). If you are really brave and want to take a chance, tramadol (works rapidly usually, but if it ever poops out it is very hard to get off).
Can you reduce or eliminate seroquel? I mean, with pani-sad ongoing, how useful is it? People here know I despise antipsychotics. Just how I feel from my experience with them. Short term, ok, longterm bad news. And actually, the very symptoms of pani-sad are not uncommonly caused by antipsychotics, even in low doses.
Just some ideas. Play with lorazepam. Xanax. Paxil. Effexor. On the fringe, tramadol. Eliminate antipsychotics.
I'm sure there are some really good ideas out there to add to my own thoughts, so I hope some more people will show up.
Posted by dreamboat_annie on January 6, 2007, at 0:43:51
In reply to Re: I call it, 'Pani-sad.' :), posted by cgd092 on January 4, 2007, at 14:43:56
I don't have much to offer, but I do know what you are going through. My first depression was very much "pani-sad". For me, when anxiety gets way too out of control, I get very, very depressed.
What helped me when I had my first depression, and kept me in a very productive remission for about 6 years, was a combination of Paxil and Xanax (which Blueberry has spoken about). Paxil completely destroyed the panic/anxiety/constant worry and the Xanax did also. Xanax still to this day can pull me out of an anxious funk better than anything really. I was an idiot and stopped the Paxil and when I tried it again, it didn't work for me. I am on Lexapro now, with Xanax as needed, and it seems to be working. It has only been 12 days, but, so far so good.
Good luck to you. I hope you find something that helps. Pani-sad is horrendous.
Posted by Phillipa on January 6, 2007, at 18:46:34
In reply to Re: I call it, 'Pani-sad.' :) » cgd092, posted by Phillipa on January 4, 2007, at 21:53:07
Wow my first ad with the xanax and did well after about three months. I did the same thing quit it and it didn't work again and so far nothing else either. So on the lexapro did you have horrendous anxiety? I tried it once and did. Love Phillipa
Posted by dreamboat_annie on January 6, 2007, at 19:17:18
In reply to Re: I call it, 'Pani-sad.' :) » Phillipa, posted by Phillipa on January 6, 2007, at 18:46:34
So on the lexapro did you have horrendous anxiety? I tried it once and did. Love Phillipa
No, I was really surprised. With the exception of a bit of nausea and an increase in my insomnia, I have had virtually no side effects. I was a bit concerned at first because I thought that the lack of side effects would mean that it wouldn't work. But, I have been pleasantly surprised. That being said, the first few weeks I was on Paxil, my anxiety increased probably 10-fold. It was excrutiating. Not to mention the other side effects I experienced. I was ready to stop then and there, but my doctor told me to take Xanax as needed during the start-up phase (which meant frequently) and the side-effects should subside (which they did). So, I think if you can stick it out on the Lexapro for 3 - 4 weeks, even with the increased anxiety, it may be worth it. Perhaps if you decide to re-try Lex and give it a longer trial, you could take Xanax as needed during the day to quell the increased anxiety that may occur as a start-up side effect. I know it's early yet for me, but my anxiety has decreased tremendously since starting the Lex and I feel more comfortable in my own skin again. I don't feel nervous and apprehensive like I had been feeling. It's nice.
Posted by Phillipa on January 6, 2007, at 20:36:12
In reply to Re: I call it, 'Pani-sad.' :) » Phillipa, posted by dreamboat_annie on January 6, 2007, at 19:17:18
What dose are you taking? I've been sticking to luvox for years out of fear and no relief of anxiety or depression even on valium. Love Phillipa
Posted by cgd092 on January 7, 2007, at 0:34:42
In reply to Re: I call it, 'Pani-sad.' :) » cgd092, posted by blueberry1 on January 5, 2007, at 23:41:31
blueberry wrote, "Pani-sad. Good word, horrible way to feel...Xanax instead of lorazepam? But before that, try doubling the dose of lorazepam for 3 days to see if...it helps anxiety...if it worsens depression, helps it, or no difference....
Paxil. When hundreds of general practioners were surveyed to find out what they thought were the best ssri's in terms of efficacy for anxiety and depression, paxil was at the top of the list."
Thank you for all these ideas. I saved them in a .doc file. I actually mentioned Paxil before to my pdoc. There are two schools of thought, it seems. That if one antidepressant poops out, switch. The other school of thought is if your AD poops out; up the dose, higher and higher. My pdoc is the latter. When I suggested Paxil a month ago, when it seemed my Celexa was pooping out, she said "one is as good as another" re: the SSRI's and said just go up on the Celexa. Well, I did, but then later she told me to go back down, because it seemed to be causing more anxiety. Duh, of course. SSRI's can be too stimulating sometimes. So I'm going to keep the Paxil idea in my back pocket as "hope." In case depression gets bad again. I like your idea about going down on the Seroquel. And not to be so afraid of the Benzos. Thanks to everyone!!--Katy
Posted by dreamboat_annie on January 7, 2007, at 22:03:50
In reply to Re: I call it, 'Pani-sad.' :) » dreamboat_annie, posted by Phillipa on January 6, 2007, at 20:36:12
> What dose are you taking? I've been sticking to luvox for years out of fear and no relief of anxiety or depression even on valium. Love Phillipa
-- I have been taking 10mg and then 15mg every third day. That seems to be working. I think the 10mg works, but I am in PMS right now and need a little extra it seems.I know it's scary to start a new med. I a person who is scared to take cold medicine LOL. I've had insomnia for ages and ages, and even bought Tylenol Simply Sleep but have been scared to take it. I'm a freak! But, if I want to feel better in the long run, I have had to overcome the fears and give the meds a chance to work (even if I have to put up with the unpleasant side effects to start with). If I had given up on Paxil all the years ago when I had such horrid side effects in the beginning, I would have been struggling for a long time.
Anyway, you have to do what is right for you. When you are ready, you will try something new and, who knows, maybe you will be pleasantly surprised.
Take care.
This is the end of the thread.
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