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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 27. This is the beginning of the thread.
Posted by Phillipa on January 30, 2007, at 12:49:00
I read the ambien post above and have been on 3mg of lunesta, l5mg of valium, and .5 of xanax at night for sleep and 50mg of luvox is this safe as I am sleeping. Thanks Phillipa
Posted by tensor on January 30, 2007, at 15:18:43
In reply to Valium, xanax, lunesta together at night for sleep, posted by Phillipa on January 30, 2007, at 12:49:00
I don't think there's a reason to worry. Adding it up you could perhaps say it roughly responds to 2mg of Xanax.
/Mattias
Posted by Quintal on January 30, 2007, at 17:31:55
In reply to Valium, xanax, lunesta together at night for sleep, posted by Phillipa on January 30, 2007, at 12:49:00
Phillipa, I and some other people on here have been trying for a while to inform you that benzos and other CNS depressants can cause and exacerbate depression when taken long term. It's one of the reasons pdocs are so against benzos here in the UK and if you were to present with treatment resistant depression it would probably be one of their treatment goals to gradually taper them off them and see if your depression improved. I found myself that I no longer have such severe depressive episodes since I quit benzos and I'm more emotionally stable. It really is worth looking into withdrawing from them and substituting with another anxiolytic drug such as Lyrica and/or BuSpar (if necessary) if you're serious about beating the depression.
I know benzos are the only meds you trust and they've worked well most of your life, but it is possible that now they're doing more harm than good.
Q
Posted by sdb on January 30, 2007, at 17:56:20
In reply to Re: Valium, xanax, lunesta together at night for sleep, posted by Quintal on January 30, 2007, at 17:31:55
> Phillipa, I and some other people on here have been trying for a while to inform you that benzos and other CNS depressants can cause and exacerbate depression when taken long term. It's one of the reasons pdocs are so against benzos here in the UK and if you were to present with treatment resistant depression it would probably be one of their treatment goals to gradually taper them off them and see if your depression improved. I found myself that I no longer have such severe depressive episodes since I quit benzos and I'm more emotionally stable. It really is worth looking into withdrawing from them and substituting with another anxiolytic drug such as Lyrica and/or BuSpar (if necessary) if you're serious about beating the depression.
>
> I know benzos are the only meds you trust and they've worked well most of your life, but it is possible that now they're doing more harm than good.
>
> QI think that it can be various from person to person. If there's only an anxiety problem benzos can have something like an antidepressant effect because of the relief of a problem. If somebody has depression and anxiety things are more complicated. Valium and especially Klonopin do have the property to probably induce symptoms of depression. The only benzo with antidepressant action by itself is prazepam. I tested both, prazepam and chlordiazepoxide. I was surprised why prazepam had an antidepressant effect and chlordiazepoxide not since the pharmacodynamic profile is similar but not the same (but no diazepam as main substance). It is not everything explainable by theory. I don't know about alprazolam, I've taken an XR 1mg and only felt sedated. What's definitely clear is that benzos of course are one of the most effective treatments against anxiety disorders.
Bupirone can be a treatment for anxiety but I am not sure if it is more because of an antidepressant action. 5ht1a antagonists definitaly works against depression/anxiety. One example which is a betablocker with high affinity to 5ht1a-receptors is bopindolol. It is the only betablocker that has a good impact on mood disorders available due to its pharmacological profile.
sdb
Posted by Quintal on January 30, 2007, at 18:17:18
In reply to Re: Valium, xanax, lunesta together at night for s, posted by sdb on January 30, 2007, at 17:56:20
>I think that it can be various from person to person.
It does, and that's why a trial withdrawal is the only way for each person to test if they are becoming depressed from the benzos.
>If there's only an anxiety problem benzos can have something like an antidepressant effect because of the relief of a problem.
I know what you mean. When I took Klonopin for the first time I felt almost euphoric from the relief. It was like walking out of prison after 19 years. Over the years I became more emotionally labile and suicidal but I denied this had anything to do with the benzos for the reason mentioned above. It's only since I (was forced) to quit benzos that I can look back over my behaviour and see how much they were affecting me. This isn't some anti-benzo sentiment though - I really do think a *gradual* tapered withdrawal in conjunction with other anxiolytics is worth trying in somebody who has TRD after taking benzos for decades.
>Bupirone can be a treatment for anxiety but I am not sure if it is more because of an antidepressant action.
Buspirone seemed to have little effect on me except improving my sense of taste and smell when I was withdrawing form Klonopin, but it was a severe withdrawal (20mg cold turkey). I know one guy who swears it's the only drug that really works for him though.
Q
Posted by sdb on January 30, 2007, at 18:31:39
In reply to Re: Valium, xanax, lunesta together at night for s, posted by Quintal on January 30, 2007, at 18:17:18
> >I think that it can be various from person to person.
>
> It does, and that's why a trial withdrawal is the only way for each person to test if they are becoming depressed from the benzos.
>
> >If there's only an anxiety problem benzos can have something like an antidepressant effect because of the relief of a problem.
>
> I know what you mean. When I took Klonopin for the first time I felt almost euphoric from the relief. It was like walking out of prison after 19 years. Over the years I became more emotionally labile and suicidal but I denied this had anything to do with the benzos for the reason mentioned above. It's only since I (was forced) to quit benzos that I can look back over my behaviour and see how much they were affecting me. This isn't some anti-benzo sentiment though - I really do think a *gradual* tapered withdrawal in conjunction with other anxiolytics is worth trying in somebody who has TRD after taking benzos for decades.
>
> >Bupirone can be a treatment for anxiety but I am not sure if it is more because of an antidepressant action.
>
> Buspirone seemed to have little effect on me except improving my sense of taste and smell when I was withdrawing form Klonopin, but it was a severe withdrawal (20mg cold turkey). I know one guy who swears it's the only drug that really works for him though.
>
> Q
>
>Theres's another option. No drugs. But I've my coffee next me and should sleep now.
I am not sure, Phillipa, if it would make sense to slowly switch from Valium to a higher dosage Librium and to up Xanax. You said that you have a tolerance to Xanax. Bad that you're sensitive to SSRI's. But I can understand this. I can't take benzos longterm. I've taken them only occasionally like a glass of wine. Wine has a better taste.@--->--- sdb
Posted by sdb on January 30, 2007, at 18:38:01
In reply to Re: Valium, xanax, lunesta together at night for s, posted by Quintal on January 30, 2007, at 18:17:18
> >I think that it can be various from person to person.
>
> It does, and that's why a trial withdrawal is the only way for each person to test if they are becoming depressed from the benzos.
>
> >If there's only an anxiety problem benzos can have something like an antidepressant effect because of the relief of a problem.
>
> I know what you mean. When I took Klonopin for the first time I felt almost euphoric from the relief. It was like walking out of prison after 19 years. Over the years I became more emotionally labile and suicidal but I denied this had anything to do with the benzos for the reason mentioned above. It's only since I (was forced) to quit benzos that I can look back over my behaviour and see how much they were affecting me. This isn't some anti-benzo sentiment though - I really do think a *gradual* tapered withdrawal in conjunction with other anxiolytics is worth trying in somebody who has TRD after taking benzos for decades.
>
> >Bupirone can be a treatment for anxiety but I am not sure if it is more because of an antidepressant action.
>
> Buspirone seemed to have little effect on me except improving my sense of taste and smell when I was withdrawing form Klonopin, but it was a severe withdrawal (20mg cold turkey). I know one guy who swears it's the only drug that really works for him though.
>
> Q
>
>Q, it's interesting to hear your experience, thanks :-)
Good night!
Posted by Phillipa on January 30, 2007, at 19:28:04
In reply to Re: Valium, xanax, lunesta together at night }} Q, posted by sdb on January 30, 2007, at 18:38:01
Yes even the benzos vary in side effects. As I took klonopin at one point and it depressed me so much I felt suicidal. Called my pdoc he said go off the klonopin and back on the xanax and it did the trick . I was fine in less than an hour. Xanax worked well for me until I asked to be switched. I have an appointment Thursday with my pdoc and will see if she'll make the switch. As having something during the day definitely made a differnce then. And I've cut 5mg of valium out just like that since I started the lunesta. Love Phillipa ps anxiety leads to depression in me.
Posted by dbc on January 30, 2007, at 19:45:24
In reply to Re: Valium, xanax, lunesta together at night }} Q, posted by Phillipa on January 30, 2007, at 19:28:04
Xanax has been show to have anti-depressant effects.
"These data provide further support for the hypothesis that the GABA/benzodiazepine/Cl complex is directly implicated in the action of antidepressants and that systems other than the GABA system are involved in the antidepressant and anxiolytic effects of alprazolam."
reference:http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1355436&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2833319&dopt=Abstract
I dont care for the anti benzo hysteria of the british shrinks and they need to do their homework.
Posted by Quintal on January 30, 2007, at 20:40:10
In reply to Re: Quintal + alprazolam, posted by dbc on January 30, 2007, at 19:45:24
Clonazepam has also been shown to have antidepressant and is suspected to have mood stabilizing effects, yet as we've seen, in practice it can be somewhat contrary.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10880686&dopt=Abstract
__________________________________________________A marked antidepressive effectiveness of clonazepam was suggested also by a drop of the total HAMD and FKD score already after the first week of treatment.
__________________________________________________http://www.ingentaconnect.com/content/els/0924977x/2003/00000013/00000002/art00174
>I dont care for the anti benzo hysteria of the british shrinks and they need to do their homework.
Nor do I, but what happened in Britain was not hysteria on behalf of the psychiatrists, it was the general public (many of whom had become addicted to benzos against their will) that pressurized the government into legislating against benzos. Benzos are still prescribed where necessary but they are rarely used long-term in young people unless they fail to respond to more acceptable treatments. Nevertheless from the age of 19 I received prescriptions for seven different benzos and 'Z-drugs', sometimes taking three at the same time with my GP's consent (diazepam, lorazepam and zopiclone).
Xanax isn't available on the NHS here so they can't prescribe it. My second pdoc said he would give me Xanax if he could - he worked and did some of his training in Canada. I bought a script for Xanax privately anyway and it did nothing for me. It was like a placebo despite its high potency.
Q
Posted by valene on January 30, 2007, at 20:45:58
In reply to Re: Valium, xanax, lunesta together at night for sleep, posted by Quintal on January 30, 2007, at 17:31:55
> Phillipa, I and some other people on here have been trying for a while to inform you that benzos and other CNS depressants can cause and exacerbate depression when taken long term. It's one of the reasons pdocs are so against benzos here in the UK and if you were to present with treatment resistant depression it would probably be one of their treatment goals to gradually taper them off them and see if your depression improved. I found myself that I no longer have such severe depressive episodes since I quit benzos and I'm more emotionally stable. It really is worth looking into withdrawing from them and substituting with another anxiolytic drug such as Lyrica and/or BuSpar (if necessary) if you're serious about beating the depression.
>
> I know benzos are the only meds you trust and they've worked well most of your life, but it is possible that now they're doing more harm than good.
>
> QI have a different opinion, Q. My own experience has been that xanax has definite antidepressant properties and I have been taking it for 25 years, and have gone down from 3mg. to 1.75mg. or less.
Phillipa has not gone up in her benzo dosage; in fact she has gone down if I am not mistaken. So as far as tolerance is concerned I don't think she has an issue.
I saw a famous psychopharmacologist in Boston because I was concerned about coming off the xanax, and he recommended that I stay on a small dose because a) it helps anxiety b) I do not increase dosage,
c) it is safe to take d) hardly drink alcohol.Val
Posted by Phillipa on January 30, 2007, at 21:00:52
In reply to Re: Quintal + alprazolam, posted by dbc on January 30, 2007, at 19:45:24
I agree . As per posts from UK posters they would prefer to see their patients have a couple of drinks in the evening. Just how I feel. Love Phillipa alchohol worked for me too. But here in the US nightly drinking is not good
Posted by Phillipa on January 30, 2007, at 21:07:11
In reply to Re: Valium, xanax, lunesta together at night for s » Quintal, posted by valene on January 30, 2007, at 20:45:58
Valene you are l00% correct and I'm thinking of switching back to xanax on Thursday if my pdoc will let me as I never took more than 2mg . And if my current combo only equals 2mg of xanax look at the money I will save too. And I no longer drink. Love Phillipa
Posted by notfred on January 30, 2007, at 21:18:50
In reply to dbc + alprazolam + clonazepam » dbc, posted by Quintal on January 30, 2007, at 20:40:10
For me benzos are key to keeping the depression in check. Enough stress and the depression will break through.
Posted by Quintal on January 30, 2007, at 21:34:00
In reply to Re: Valium, xanax, lunesta together at night for s » Quintal, posted by valene on January 30, 2007, at 20:45:58
> I have a different opinion, Q. My own experience has been that xanax has definite antidepressant properties and I have been taking it for 25 years, and have gone down from 3mg. to 1.75mg. or less.
>Yours seems to be a fairly common experience Val. Xanax is well noted as being an exception in having antidepressant effects. However, I am still completely at ease with the theory that most benzos can cause and exacerbate depression in susceptible people when taken at high doses for long periods of time, in line with other CNS depressants.
>Phillipa has not gone up in her benzo dosage; in fact she has gone down if I am not mistaken. So as far as tolerance is concerned I don't think she has an issue.
Nowhere in my post did I mention problems with abuse or tolerance, though now you've raised the issue Phillipa has posted several times that the benzos no longer have the same beneficial effect - highly suggestive of tolerance. But that isn't the point I was making. Many benzos are known to exacerbate depression and Phillipa is taking two benzos and a third benzodiazapine-like drug, all of which in combination could be contributing to depression. My suggestion was a trial withdrawal from these drugs with non-benzodiazepine anxiolytics if necessary, but I agree; a switch Xanax first seems the best step to take.
Q
Posted by sdb on January 31, 2007, at 2:50:14
In reply to Re: Valium, xanax, lunesta together at night for s » valene, posted by Phillipa on January 30, 2007, at 21:07:11
> Valene you are l00% correct and I'm thinking of switching back to xanax on Thursday if my pdoc will let me as I never took more than 2mg . And if my current combo only equals 2mg of xanax look at the money I will save too. And I no longer drink. Love Phillipa
Phillipa I agree. Drinking over long term isn't the solution even if alcohol is effective. When I see the pathologies of alcoholics it is terrible. Only the taste in very small portions of French wine can be good. Better a benzo e.g. Xanax.
Love sdb
Posted by yxibow on February 1, 2007, at 0:05:48
In reply to Re: Quintal + alprazolam » dbc, posted by Phillipa on January 30, 2007, at 21:00:52
> I agree . As per posts from UK posters they would prefer to see their patients have a couple of drinks in the evening. Just how I feel. Love Phillipa alchohol worked for me too. But here in the US nightly drinking is not good
Nightly drinking to cover a problem that could just as well be solved with a benzodiazepine is not a good thing. Drinking for the sake of enjoyment is one thing, but drinking to medicate away oneself, well, there's a dichotomy.
Its much less harsh on the liver to have a little Valium every day than to consistently drink and most psychiatrists here would agree with that statement whether they like benzodiazepines or not.
Doesn't mean though that a little wine if one already drinks for the taste of it is a bad thing -- I mean, they always go back and forth in the news about the benefits of small amounts of alcohol and wine.
Its when you get to the six pack a night that you enter, besides excess calories alone, a zone that is just not healthy for the body. Alcohol in large quantities for years can even cause tardive dyskinesia though this is rare. But definately that path is a sign of possible alcoholism. Save the liver, you can live on 10% of it, but why go there?
As for multiple sleep agents -- in moderation, sure, some people require it. I do take more than one at the moment.
But there's also the habituation of a regime of taking any sleep agent for insomnia over time that creates a pattern. Granted I have other things to address at the moment in my life so I can't change that but it was pointed out by my psychiatrist that there also is the option of no sleep agent. Eventually the body will take over, but its a time period that a lot of us just can't tolerate, and makes one cranky, and possibly in danger of falling asleep at inopportune times, and unproductive work. Other things may contribute to insomnia such as excessive naps, and sleep apnea.-- tidings
Posted by XanyADDam on February 1, 2007, at 3:01:12
In reply to Valium, xanax, lunesta together at night for sleep, posted by Phillipa on January 30, 2007, at 12:49:00
> I read the ambien post above and have been on 3mg of lunesta, l5mg of valium, and .5 of xanax at night for sleep and 50mg of luvox is this safe as I am sleeping. Thanks Phillipa
Hey, Phillipa, I take 10 to 20 mg of Ambien along with 300 mg of Lyrica...and 1 mg of Xanax at night for sleep. Along with 1500 mg of Depakote. I strongly doubt what we're doing is dangerous...sometimes I don't even sleep, yet I've got all these depressants in my bloodstream.
Posted by Phillipa on February 1, 2007, at 22:42:05
In reply to Re: Valium, xanax, lunesta together at night for sleep, posted by XanyADDam on February 1, 2007, at 3:01:12
Saw my pdoc again today and she prescribed the l5mg of valium .5 of xanax and said up the luvox at night and stay on the 3mg of lunesta and if things go well add trileptal it will relax too. Now trileptal I have to google as it's a mood stabizer and my mood is stable so don't know how this would help with anxiety? Anyone know? Love Phillipa ps still would rather have the drinks and think of the money you save.
Posted by yxibow on February 2, 2007, at 0:25:09
In reply to Re: Valium, xanax, lunesta together at night for sleep » XanyADDam, posted by Phillipa on February 1, 2007, at 22:42:05
> Saw my pdoc again today and she prescribed the l5mg of valium .5 of xanax and said up the luvox at night and stay on the 3mg of lunesta and if things go well add trileptal it will relax too. Now trileptal I have to google as it's a mood stabizer and my mood is stable so don't know how this would help with anxiety? Anyone know? Love Phillipa ps still would rather have the drinks and think of the money you save.
Trileptal is an AED and is used to challenge anxiety and agitation and especially bipolar; it is oxcarbazepine and has far fewer side effects than its older relative carbamazapine which had issues with low white blood cell count. Its more subtle and may take a while to work, if it does anything at all.
It has been one of the many things that have passed through the chain of AEDs I've tried; for me it possibly caused a side effect in another medication so I can't say whether it would have had benefit or not, we had to discontinue it. But that's just my polypharmacy, not yours.
Drinks for pleasure as I mentioned elsewhere is a multi thousand year old custom of humanity. Drinks to self-medicate, while we may all do this occasionally are more toxic to the liver than just increasing the Valium dose a bit. A six pack a night is a bad sign that something else really is needed.Besides that's like 600 calories you could use on something far more nutritious or interesting. The money you save may seem low in the short run but in the long run, do you really want cirrhosis?
-- tidings
Posted by steve59 on February 12, 2007, at 19:07:35
In reply to Re: Valium, xanax, lunesta together at night for sleep » XanyADDam, posted by Phillipa on February 1, 2007, at 22:42:05
Posted by sdb on April 26, 2007, at 11:17:16
In reply to Re: Valium, xanax, lunesta together at night for s, posted by sdb on January 30, 2007, at 17:56:20
> > Phillipa, I and some other people on here have been trying for a while to inform you that benzos and other CNS depressants can cause and exacerbate depression when taken long term. It's one of the reasons pdocs are so against benzos here in the UK and if you were to present with treatment resistant depression it would probably be one of their treatment goals to gradually taper them off them and see if your depression improved. I found myself that I no longer have such severe depressive episodes since I quit benzos and I'm more emotionally stable. It really is worth looking into withdrawing from them and substituting with another anxiolytic drug such as Lyrica and/or BuSpar (if necessary) if you're serious about beating the depression.
> >
> > I know benzos are the only meds you trust and they've worked well most of your life, but it is possible that now they're doing more harm than good.
> >
> > Q
>
> I think that it can be various from person to person. If there's only an anxiety problem benzos can have something like an antidepressant effect because of the relief of a problem. If somebody has depression and anxiety things are more complicated. Valium and especially Klonopin do have the property to probably induce symptoms of depression. The only benzo with antidepressant action by itself is prazepam. I tested both, prazepam and chlordiazepoxide. I was surprised why prazepam had an antidepressant effect and chlordiazepoxide not since the pharmacodynamic profile is similar but not the same (but no diazepam as main substance). It is not everything explainable by theory. I don't know about alprazolam, I've taken an XR 1mg and only felt sedated. What's definitely clear is that benzos of course are one of the most effective treatments against anxiety disorders.
>
> Bupirone can be a treatment for anxiety but I am not sure if it is more because of an antidepressant action. 5ht1a antagonists definitaly works against depression/anxiety. One example which is a betablocker with high affinity to 5ht1a-receptors is bopindolol. It is the only betablocker that has a good impact on mood disorders available due to its pharmacological profile.
>
> sdbIt is interesting that bopindolol does not have cyp450 biotransformation. It is transformed by esterase.
http://www.blackwell-synergy.com/doi/pdf/10.1111/j.1527-3466.2001.tb00180.x
Posted by Phillipa on April 26, 2007, at 20:13:17
In reply to Re: Valium, xanax, lunesta together at night for s, posted by sdb on April 26, 2007, at 11:17:16
sdb I appreciate your concern but this is the regime my pdoc wants me on now and the other one was worse upping the benzos. So for now this is it with the long term goal of upping luvox and downing valium to l5-20mg again from the outrageous amount the pdoc here prescribed can you belive first it was 6mg of xanax one week, week two real deal and then week three 8mg of ativan which I refused. love Phillipa oh I've been on buspar doesn't work for me and pdoc said no to lyrica.
Posted by sdb on May 7, 2007, at 7:27:23
In reply to Re: Valium, xanax, lunesta together at night for s » sdb, posted by Phillipa on April 26, 2007, at 20:13:17
> sdb I appreciate your concern but this is the regime my pdoc wants me on now and the other one was worse upping the benzos. So for now this is it with the long term goal of upping luvox and downing valium to l5-20mg again from the outrageous amount the pdoc here prescribed can you belive first it was 6mg of xanax one week, week two real deal and then week three 8mg of ativan which I refused. love Phillipa oh I've been on buspar doesn't work for me and pdoc said no to lyrica.
dear Phillipa
40mg of valium is probably too much. I am not sure how you respond to luvox and if it would make sense to lower the dosage. If you think that this would be better for you then do it cautiously.
Librium (chlordiazepoxide) is still an option even if it is only considered as a weak benzo. Librium is definitely not weak if you take 25mg 3x times a day and at this dosage it is still less sedating than valium. Valium and especially Klonopin are more depressogenic. I don't think that 5htp is better than luvox or another med. But there you probably ask other people with experience taking this.love sdb
ps. take care of infections
Posted by Phillipa on May 7, 2007, at 18:59:47
In reply to Re: Valium, xanax, lunesta }} phillipa, posted by sdb on May 7, 2007, at 7:27:23
Sdb what infections? Love Phillipa the chronic lymes supposedly had enough antibiotics by standards here.
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