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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 your#1fan on March 16, 2008, at 0:58:10
I've been reading articles that Zyprexa, and MANY of people i know take Seroquel, for anxiety.
Those days of real anti-anxiety things are gone. We need to have revival.
But at the same time, during the the 1970's and 1980's benzo's where prescribed (1975- diazepam was one the most widely prescibed medication)
In 1985 the banned Quulude, and took a diffrent way of treating anxiety by using SSRI's and now today, its mostly Nueroleptics.
What next for anxiety?
fan
Posted by yxibow on March 16, 2008, at 4:10:12
In reply to The new way of calming people down, posted by your#1fan on March 16, 2008, at 0:58:10
> I've been reading articles that Zyprexa, and MANY of people i know take Seroquel, for anxiety.
>
> Those days of real anti-anxiety things are gone. We need to have revival.
>
> But at the same time, during the the 1970's and 1980's benzo's where prescribed (1975- diazepam was one the most widely prescibed medication)
>
> In 1985 the banned Quulude, and took a diffrent way of treating anxiety by using SSRI's and now today, its mostly Nueroleptics.
Benzodiazepines actually date to 1962 (1959 or so in the lab) and can be said to be among the safest psychiatric medication when used exactly as directed. They replaced barbiturates which had a low safety profile, and are rarely used, at least in the US.
Quaaludes turned out to be rather dangerous, and similar to barbiturates.Miltown also went out of favour and became scheduled -- its rarely used if even obtainable today. Soma converts into miltown.
> What next for anxiety?
>
> fanWell severe anxiety conditions are still handled by Zyprexa or Seroquel for their low potency and relative safety in lower doses.
Yes, what is next for the future. A recovery model for one is gaining rounds in psychiatry -- not aggressively treating the patient with medications but using the minimum effective medications and outpatient therapy. Unfortunately most insurance companies don't pay for a lot of therapy. Its an underused model and a focus of NAMI as well.
For that that can't be controlled otherwise, of course there's the usual panoply of AEDs, but one has to be cautious because a few, like Keppra apparently can make some patients more psychotic, and Gabitril can cause seizures ironically. These are generalisms, some people out there may be perfectly fine on them.
A small number of patients respond to BuSpar, although the dose may have to be somewhat high and it can cause dizziness.
There are TRIs in the pipeline (triple reuptake inhibitors -- SE, NE, and DA), although they are a ways off and probably more angled towards depression.
Tertiary agents such as propranolol are sometimes used to control the symptoms but not the root cause, as is clonidine or guanfacine often for rage in ADHD, but sometimes anxiety. The two shouldn't be mixed particularly (heart issues).
But as said before, ultimately, "calming people down" in a pill can be like chasing rainbows. A lot of hard work and maybe it sounds new age or non-psychiatric, but they are actually tools, relaxation therapy, guided imagery, deep breathing, and other exercises to help a patient help themselves calm down.
Now this isn't naiveté for the catatonic patient on PCP who really needs a hospital stay and an antipsychotic to stabilize themselves. Some things have to be solved a bit aggressively. But not everything
-- Jay
Posted by Phillipa on March 16, 2008, at 12:05:02
In reply to Re: The new way of calming people down » your#1fan, posted by yxibow on March 16, 2008, at 4:10:12
Miltown was given to me with valium in the 70's and it worked well. I just stopped taking it when I felt better. I wonder why there wasn't some withdrawal? So far theraphy isn't doing much for me but I have to get back to it. I hope. Phillipa
Posted by Racer on March 16, 2008, at 14:03:52
In reply to The new way of calming people down, posted by your#1fan on March 16, 2008, at 0:58:10
>
> Those days of real anti-anxiety things are gone. We need to have revival.
>I just wondered if you'd thought about what you mean by "real anti-anxiety things?" It seems to me that, if it works to reduce anxiety, it *is* a "real anti-anxiety thing." The old anti-psychotics were known as "heavy tranquilizers," even though they were used primarily for psychosis.
Part of the reason I wondered about this is very personal: I'm one of those people who reacts badly to benzodiazepines. If I take a benzo while mostly calm, it isn't so bad -- although it's definitely not good -- but if I take one during what passes in me for a panic attack, I have a paradoxical reaction, and get much more agitated, much more panicked, and generally worse off than before taking the medication. When people talk about anxiolytics, I actually feel kinda frustrated, since nothing I've tried has helped me much.
(For the record, BuSpar did help me, but it came with side effects I couldn't handle -- turned me into a zombie, which increased my depression.)
OK, I'm done. Just wanted to ask what you meant on that one, and ended up telling my sad tale...
Posted by Phillipa on March 16, 2008, at 19:27:58
In reply to I wonder what you mean by this? » your#1fan, posted by Racer on March 16, 2008, at 14:03:52
I remember another poster had the same reactions to valium. Couldn't tolerate it From UK and ended up in CBT I think. So it must be common. Phillipa
Posted by yxibow on March 16, 2008, at 20:44:11
In reply to Re: I wonder what you mean by this? » Racer, posted by Phillipa on March 16, 2008, at 19:27:58
> I remember another poster had the same reactions to valium. Couldn't tolerate it From UK and ended up in CBT I think. So it must be common. Phillipa
Its called an idiosyncratic drug reaction, one without a definition, thought possibly to do with individual immune responses.
Posted by your#1fan on March 17, 2008, at 1:33:03
In reply to Re: The new way of calming people down » your#1fan, posted by yxibow on March 16, 2008, at 4:10:12
yxibow, thank you so much for you long responses. Rerember that i go back sometimes and will read what people will put to me.
Yea.... the new age techniques i have panic attacks in just doing those, benzo's have helped me so much. The only barbiturate that i thought about to replace Xanax was Phenobarbital (but i read it was terrible, made you feel horrible, slow, drunk, dumb) no thanks:)
Ill document this post...i like to go back to some posts to questions i've already asked.your#1fan
Posted by your#1fan on March 17, 2008, at 1:35:38
In reply to Re: The new way of calming people down » yxibow, posted by Phillipa on March 16, 2008, at 12:05:02
Phenobarbtial was the only thing i was thinking about telling the doctor about. I really dont he would script the forgotten "candy" medicaiton Miltown.
He already said no on Diazepam, but thinks Xanax is best for me.
Sorry its late tonighgt....been on the web....came to dr-bob last. BUT NOT LEAST!
your#1fan
Posted by your#1fan on March 17, 2008, at 1:38:45
In reply to I wonder what you mean by this? » your#1fan, posted by Racer on March 16, 2008, at 14:03:52
heavy tranquiliers would knock my sock off, Haldol and Thorazine, there too much, i would have no life inside me. But i have thought taken them at times (because i think im going crazy)
Xanax mainly is taken for me during the day when i feel a "steel" in my stomache, and it feels like there an engine running! or a panic attack (but Xanax doenst help with dealing with all reality, if i lose something, im still screwed)
Thank;0
y0ur#1fan
Posted by yxibow on March 17, 2008, at 3:03:19
In reply to Racer, posted by your#1fan on March 17, 2008, at 1:38:45
> heavy tranquiliers would knock my sock off, Haldol and Thorazine, there too much, i would have no life inside me. But i have thought taken them at times (because i think im going crazy)
>
> Xanax mainly is taken for me during the day when i feel a "steel" in my stomache, and it feels like there an engine running! or a panic attack (but Xanax doenst help with dealing with all reality, if i lose something, im still screwed)
>
> Thank;0
>
> y0ur#1fanThere is some limited documentation for high dosage Valium -- which I think has helped me in the past, as far as "reality" and "functionality", unfortunately it has caught up with me and it is very hard to go down on it without something affecting "functionality" -- so if anything, its really small reductions, plus my condition seems to have morphed itself, its a very baffling and unpleasant place to be but in the end I have to make a life. Its hard talking about yourself in the third person, sort of fatalistic, because you don't believe in the success that others around you can see in you.
Posted by Phillipa on March 17, 2008, at 19:23:36
In reply to Re: Racer » your#1fan, posted by yxibow on March 17, 2008, at 3:03:19
Jay oh I agree with you so much. Valium you're going down off of? Love Phillipa
Posted by yxibow on March 19, 2008, at 3:01:43
In reply to Re: Racer » yxibow, posted by Phillipa on March 17, 2008, at 19:23:36
> Jay oh I agree with you so much. Valium you're going down off of? Love Phillipa
I have been slowly and now extremely slowly and its been parked for a while.
If I go down on it more while I'm attempting to do therapeutic assignments I run the risk of extreme withdrawal effects that aren't what you would assume -- my anxiety comes out in so many other ways that the gastrointestinal upset pales to having my "functionality" reduced.
I don't want long periods of time where my parents have to help a few aspects of my life and I feel extremely trapped because there may be days on end when I don't drive.
Yet, in the same tone there will come a time eventually that I either reduce it 5mg at a time over weeks (most people do NOT have to do this medically and evidence based, I have multiple pickles you could say that I am in, but this is life in the Here and Now) -- eventually get to a point where I can reduce it and try Clozaril or just accept the benefits of Seroquel far exceeding risks for some indefinite time.
Its not a place I like to be, but I think the thing to focus on is what I can do and not think of myself as permanently ill, because it doesn't help, and in fact my "functionality" has increased relatively, with some ups and downs. Its to focus on the positive things that I am capable of and the positive traits that are still there, under the mental fog, confusion, and baffling symptoms.
This is the end of the thread.
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