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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 17 of 17. This is the beginning of the thread.
Posted by floatingbridge on June 11, 2011, at 1:21:54
This is not a request for input or alternative meds. It is simply a declarative b*tch.
I feel under dosed and, yet, dopey.
You might imagine I do not like this.
I see the pdoc on Monday. I expect both something and nothing.
fb
Posted by SLS on June 11, 2011, at 5:40:39
In reply to I'm beginning to really dislike valium., posted by floatingbridge on June 11, 2011, at 1:21:54
> This is not a request for input or alternative meds.
Sorry...
Phenergan can really help with anxiety, sleep, and pain. Although it is a relative of phenothiazines, the addition of a molecular side-chain prevents it from acting as a D2 antagonist.
Phenergan (promethazine):INDICATIONS
Perennial and seasonal allergic rhinitis.
Vasomotor rhinitis.
Allergic conjunctivitis due to inhalant allergens and foods.
Mild, uncomplicated allergic skin manifestations of urticaria and angioedema.
Amelioration of allergic reactions to blood or plasma.
Dermographism.
Anaphylactic reactions, as adjunctive therapy to epinephrine and other standard measures, after the acute manifestations have been controlled.
Preoperative, postoperative, or obstetric sedation.
Prevention and control of nausea and vomiting associated with certain types of anesthesia and surgery.
Therapy adjunctive to meperidine or other analgesics for control of post-operative pain.
Sedation in both children and adults, as well as relief of apprehension and production of light sleep from which the patient can be easily aroused.
Active and prophylactic treatment of motion sickness.
Antiemetic therapy in postoperative patients.
------------------------------------------------
Phenergan (promethazine) Tablets and Phenergan (promethazine) Rectal Suppositories are contraindicated for children under 2 years of age (see WARNINGS-Black Box Warning and Use in Pediatric Patients).Phenergan (promethazine) Suppositories are for rectal administration only.
AllergyThe average oral dose is 25 mg taken before retiring; however, 12.5 mg may be taken before meals and on retiring, if necessary. Single 25-mg doses at bedtime or 6.25 to 12.5 mg taken three times daily will usually suffice. After initiation of treatment in children or adults, dosage should be adjusted to the smallest amount adequate to relieve symptoms. The administration of promethazine HCl in 25-mg doses will control minor transfusion reactions of an allergic nature.
Motion SicknessThe average adult dose is 25 mg taken twice daily. The initial dose should be taken one-half to one hour before anticipated travel and be repeated 8 to 12 hours later, if necessary. On succeeding days of travel, it is recommended that 25 mg be given on arising and again before the evening meal. For children, Phenergan (promethazine) Tablets, Syrup, or Rectal Suppositories, 12.5 to 25 mg, twice daily, may be administered.
Nausea and VomitingAntiemetics should not be used in vomiting of unknown etiology in children and adolescents (see WARNINGS-Use in Pediatric Patients).
The average effective dose of Phenergan (promethazine) for the active therapy of nausea and vomiting in children or adults is 25 mg. When oral medication cannot be tolerated, the dose should be given parenterally (cf. Phenergan (promethazine) Injection) or by rectal suppository. 12.5- to 25-mg doses may be repeated, as necessary, at 4- to 6-hour intervals.
For nausea and vomiting in children, the usual dose is 0.5 mg per pound of body weight, and the dose should be adjusted to the age and weight of the patient and the severity of the condition being treated.
For prophylaxis of nausea and vomiting, as during surgery and the postoperative period, the average dose is 25 mg repeated at 4- to 6-hour intervals, as necessary.
SedationThis product relieves apprehension and induces a quiet sleep from which the patient can be easily aroused. Administration of 12.5 to 25 mg Phenergan (promethazine) by the oral route or by rectal suppository at bedtime will provide sedation in children. Adults usually require 25 to 50 mg for nighttime, presurgical, or obstetrical sedation.
Pre- and Postoperative UsePhenergan (promethazine) in 12.5- to 25-mg doses for children and 50-mg doses for adults the night before surgery relieves apprehension and produces a quiet sleep.
For preoperative medication, children require doses of 0.5 mg per pound of body weight in combination with an appropriately reduced dose of narcotic or barbiturate and the appropriate dose of an atropine-like drug. Usual adult dosage is 50 mg Phenergan (promethazine) with an appropriately reduced dose of narcotic or barbiturate and the required amount of a belladonna alkaloid.
Postoperative sedation and adjunctive use with analgesics may be obtained by the administration of 12.5 to 25 mg in children and 25- to 50-mg doses in adults.
Phenergan (promethazine) Tablets and Phenergan (promethazine) Rectal Suppositories are contraindicated for children under 2 years of age.
Posted by Christ_empowered on June 11, 2011, at 7:20:18
In reply to Re: I'm beginning to really dislike valium. » floatingbridge, posted by SLS on June 11, 2011, at 5:40:39
valium, as you know, is more sedating than many of the more popular benzos (ativan, klonopin, xanax) and also less potent. Sounds to me like you're getting sedation without appropriate anxiety relief. Just a guess.
Could you try Ativan? Its more sedating than Klonopin, but its supposedly less addictive than Xanax and its quite popular for psychiatric issues (in mental hospitals they're always injecting people with lorazepam). I don't think it causes euphoria like xanax or depression like Klonopin, although you will need to take it (I think) 3x daily for daylong sedation. It makes a reasonably effective night-time sedative;even if it doesn't put you to sleep, it should reduce anxiety and agitation to make it easier to nod off.
Posted by SLS on June 11, 2011, at 10:59:07
In reply to Re: I'm beginning to really dislike valium., posted by Christ_empowered on June 11, 2011, at 7:20:18
> valium, as you know, is more sedating than many of the more popular benzos (ativan, klonopin, xanax) and also less potent. Sounds to me like you're getting sedation without appropriate anxiety relief. Just a guess.
>
> Could you try Ativan? Its more sedating than Klonopin, but its supposedly less addictive than Xanax and its quite popular for psychiatric issues (in mental hospitals they're always injecting people with lorazepam). I don't think it causes euphoria like xanax or depression like Klonopin, although you will need to take it (I think) 3x daily for daylong sedation. It makes a reasonably effective night-time sedative;even if it doesn't put you to sleep, it should reduce anxiety and agitation to make it easier to nod off.
Nice post.- Scott
Posted by Phillipa on June 11, 2011, at 11:28:29
In reply to Re: I'm beginning to really dislike valium. » Christ_empowered, posted by SLS on June 11, 2011, at 10:59:07
Funny when was taking .25 of xanax and had a life circumstance created huge anxiety my pdoc asked what worked for me and I said valium so he gave me 5mg. I went back to work took 5mg and just felt relaxed not tired or any of those things. Could it have been psychological? Phillipa
Posted by floatingbridge on June 11, 2011, at 11:57:14
In reply to Re: I'm beginning to really dislike valium. » SLS, posted by Phillipa on June 11, 2011, at 11:28:29
Well thanks all. CE nailed it: sedation w/ anxiety relief.
Phillipa, I could see how 5mg would be fine for work or just tooling around. It is for me. Like a light cocktail w/o alcohol sx. But that isn't what I want or need.
Guess at low dose of 5mg-10mg it could be the famous mother's helper. Not the not mother with an anxiety disorder though.
Scott, hadn't heard the other med. Will look up. Sounds otc except most likely abusable, so guess not.
Oh brother.
Hey, thanks for listening to my complaining :-/ !
fb
Posted by zonked on June 11, 2011, at 13:56:02
In reply to Re: I'm beginning to really dislike valium., posted by Christ_empowered on June 11, 2011, at 7:20:18
> Could you try Ativan? Its more sedating than Klonopin, but its supposedly less addictive than Xanax and its quite popular for psychiatric issues (in mental hospitals they're always injecting people with lorazepam). I don't think it causes euphoria like xanax or depression like Klonopin, although you will need to take it (I think) 3x daily for daylong sedation. It makes a reasonably effective night-time sedative;even if it doesn't put you to sleep, it should reduce anxiety and agitation to make it easier to nod off.
>I agree, except I find Klonopin more sedating than either Ativan or Xanax regardless of dose. Ativan never seemed to do much for my anxiety, but it didn't make my depression worse like Klonopin or Valium. Only Xanax had a neutral or, perhaps, an antidepressant effect - and really helped keep me functional. It's too bad it has such a bad reputation it does not deserve. I have not had a regular script for it since I lost my private insurance...
Valium and Klonopin "feel" similar to me. Even Sternbach, the inventor of those two drugs, has said that Valium makes makes him feel a bit depressed. (See: http://www.benzo.org.uk/valium2.htm, end of article.)
-z
Posted by floatingbridge on June 11, 2011, at 16:15:21
In reply to Re: I'm beginning to really dislike valium. » Christ_empowered, posted by zonked on June 11, 2011, at 13:56:02
Who knows? I might go back to Xanax. If I can keep the dose from rapidly escalating. That's what prompted the whole dang switch. I was good for ten years at a narrowly fluctuating, self-monitored low dose. Then, boom.
Live and, hopefully, learn.
fb
Posted by zonked on June 11, 2011, at 16:19:20
In reply to Re: I'm beginning to really dislike valium. » zonked, posted by floatingbridge on June 11, 2011, at 16:15:21
I will bring up a switch from Klonopin to either Xanax IR or XR at my next pdoc visit, myself.
As far as I am concerned, Xanax is the "gold standard" for any kind of anxiety disorder.
-z
Posted by Phillipa on June 11, 2011, at 20:11:20
In reply to Re: I'm beginning to really dislike valium. » floatingbridge, posted by zonked on June 11, 2011, at 16:19:20
Was for me also til turned on me and started making me tired during the day and only .25mg. Phillipa
Posted by sigismund on June 12, 2011, at 14:17:46
In reply to I'm beginning to really dislike valium., posted by floatingbridge on June 11, 2011, at 1:21:54
It's pretty bloody ordinary, isn't it?
They talk of gateway drugs. Nothing compares to Valium. It needs improvement.
Posted by floatingbridge on June 12, 2011, at 14:47:37
In reply to Re: I'm beginning to really dislike valium. » floatingbridge, posted by sigismund on June 12, 2011, at 14:17:46
> It's pretty bloody ordinary, isn't it?
>
> They talk of gateway drugs. Nothing compares to Valium. It needs improvement.Is valium considered a gateway drug?
I can see big non-compliance issues and escalating dosages only because in my
case, it doesn't hit the anxiety. I just get dopier and dopier. Like hanging around a cocktail hour a little too long.:(
I see my pdoc tomorrow. You get to see one exceptional person :-)
Posted by jono_in_adelaide on June 12, 2011, at 18:34:44
In reply to Re: I'm beginning to really dislike valium. » sigismund, posted by floatingbridge on June 12, 2011, at 14:47:37
Although all benzos are basicly created equal, there are individual variations, some people respond better to one, worse to another - its obvious Valium isnt right for you.
Be aware that Xanax and Ativan are much more habit forming than Valium or the other long acting benzos such as Librium, Tranxene and Frisium. Xanax however, can be very potent against severa anxiety, so is a good option when the others dont work.
Posted by sigismund on June 13, 2011, at 4:24:21
In reply to Re: I'm beginning to really dislike valium. » sigismund, posted by floatingbridge on June 12, 2011, at 14:47:37
It's more of a gateway drug than marijuana. It is a drug that (quite undersytandably) you want to add on to.
But what to do?
You have Xanax XR, which we don't. If I was where you lived, I'd choose that.
But it musn't have been that good for you because you have already tried it.The best thing is not to be habitituated to benzos which is easier said than done, as I think you agree.
Posted by floatingbridge on June 13, 2011, at 8:42:26
In reply to Re: I'm beginning to really dislike valium., posted by sigismund on June 13, 2011, at 4:24:21
I liked xanax xr. It doesn't hold up like regular xanax when the going gets tough imo. Not many folks in the states use it.
They seem to get more klonopin. I requested it. My Googling fingers :)
Yes. Best not to become habituated. But I was wrecked before I left home. I was just a case of habitual stress looking for treatment. I went through a zillion alt remedies for insomnia. :(
Posted by sigismund on June 13, 2011, at 12:44:38
In reply to Re: I'm beginning to really dislike valium. » sigismund, posted by floatingbridge on June 13, 2011, at 8:42:26
>But I was wrecked before I left home.
Well yes. I was too. I quite understand.
As I have got older I have seen how the problem was way bigger than me.
Posted by sigismund on June 13, 2011, at 12:48:32
In reply to Re: I'm beginning to really dislike valium. » sigismund, posted by floatingbridge on June 13, 2011, at 8:42:26
I prefer Xanax, but it is too unstable. It is always running out.
This is the end of the thread.
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