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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Babbler20 on October 19, 2013, at 22:49:59
Hi, I've tried every SSRI for anxiety and nothing has helped. My anxiety is so bad that I have a tremor and foot cramps all day. Are there any other good long term treatments?
Posted by Phillipa on October 19, 2013, at 23:04:20
In reply to Anxiety Treatment Needed, posted by Babbler20 on October 19, 2013, at 22:49:59
43 years of benzos and still work. Phillipa
Posted by alexandra_k on October 19, 2013, at 23:16:03
In reply to Anxiety Treatment Needed, posted by Babbler20 on October 19, 2013, at 22:49:59
i don't know a lot about it but propanalol might be worth a try. apparently it works on the peripheral nervous system rather than the central so should reduce / eliminate things like tremor while sparing the brain.
i think people are sometimes on this long term... to help keep their heart rate down or something... if their heart beats fast or something. i don't really know.
Posted by Phillipa on October 19, 2013, at 23:18:25
In reply to Re: Anxiety Treatment Needed, posted by alexandra_k on October 19, 2013, at 23:16:03
Used quite a bit by student doctors when they need to present to superiors. Short acting. But it will knock out a panic attack before it starts. I was told I couldn't use it has have thyroid issues. And yes it does slow down the heart. So also used with cardiac conditions. Phillipa
Posted by Babbler20 on October 20, 2013, at 13:21:40
In reply to Re: Anxiety Treatment Needed » Babbler20, posted by Phillipa on October 19, 2013, at 23:04:20
> 43 years of benzos and still work. Phillipa
Hi Phillipa,
Have you taken benzos every day for 42 years? Every doctor I have been to has told me that benzos only work for a couple weeks. Have you only used one benzo or do you cycle through them?
Posted by Phillipa on October 20, 2013, at 20:16:01
In reply to Re: Anxiety Treatment Needed, posted by Babbler20 on October 20, 2013, at 13:21:40
Hi there have been times where didn't take any and would take .125mg of Xanax every other day. I started on valium 5mg three times a day. Then only took as needed. When Ativan came out took this also. And then Xanax. Now take .25xanax & 5mg of valium at night. Keep cutting down as just don't seem to need them. Kind of a safety net inside I guess. Oh they most definitely work for longer than two weeks and one doesn't raise the dose unless they are looking for something other than less anxiety. Phillipa
Posted by jono_in_adelaide on October 20, 2013, at 21:27:46
In reply to Anxiety Treatment Needed, posted by Babbler20 on October 19, 2013, at 22:49:59
4 options
Buspar 10 - 20mg twice a day
Atarax (hydroxyzine)25-50mg three times a day
A low dose atypical antipsychotic (eg risperidone 0.5-1mg at bedtime)
A benzodiazepine (Valium, Xanax, Ativan etc) note that with long term use there *can* be tollorance and dependence with benzos
Posted by jono_in_adelaide on October 21, 2013, at 0:34:58
In reply to Re: Anxiety Treatment Needed, posted by jono_in_adelaide on October 20, 2013, at 21:27:46
Oh, have you tried mirtazapine?
A dose of mirtazapine (30-45mg at night) plus a benzo during the day (say Valium 5mg three times a day) could be very effective in controling anxiety
Posted by jono_in_adelaide on October 21, 2013, at 18:16:32
In reply to Re: Anxiety Treatment Needed, posted by Babbler20 on October 20, 2013, at 13:21:40
I've taken alprazolam (Xanax) every day for 5 years and its still working. I can also reduce the dose without any but the mildest withdrawl symptoms (I recently managed to go from 4mg per day to 2 mg per day, just just felt like I had a touch of stomach flu for 3 days, dull headache, a bit of malaise, and a feeling of somthing not quite right in my guts - after that all was ok)
> > 43 years of benzos and still work. Phillipa
>
> Hi Phillipa,
>
> Have you taken benzos every day for 42 years? Every doctor I have been to has told me that benzos only work for a couple weeks. Have you only used one benzo or do you cycle through them?
Posted by Hugh on October 22, 2013, at 12:14:42
In reply to Anxiety Treatment Needed, posted by Babbler20 on October 19, 2013, at 22:49:59
Many, maybe most, people can take benzos long-term without experiencing any major difficulties. But a significant portion -- maybe a third -- will run into some trouble. I took lorazepam for three years for insomnia. I increased my dosage twice because of tolerance, and then I began to suffer from inter-dose withdrawal, with lots of anxiety and terrible gastrointestinal problems. It took me four very unpleasant months to taper off benzos. I did a switch to diazepam halfway through the taper. The anxiety and insomnia I suffered during withdrawal were far worse than anything I'd suffered during my pre-benzo days.
A beta blocker like propranolol might be a better option. Some people find that niacinamide helps their anxiety. Lately I've heard that n-acetylglucosamine (NAG) can help anxiety. If there are any neurofeedback providers near you, check into that.
Posted by b2chica on October 22, 2013, at 13:55:48
In reply to Anxiety Treatment Needed, posted by Babbler20 on October 19, 2013, at 22:49:59
i have tried many things for anxiety and the best things i've tried is xanax (but can only use temp-usually only about a week or two before it messes with my cognition)
gabapentin
and Perphenazine. about 2-4mg/BID very low dose worked Fantastic for my tough anxiety.b2c
Posted by Fiat500 on October 26, 2013, at 23:23:23
In reply to Re: Anxiety Treatment Needed, posted by Hugh on October 22, 2013, at 12:14:42
I can't find any studies or info as to how n-acetyl glucosamine works for anxiety. Do you have any links? I wonder if it would have any drug interactions.
Posted by Babbler20 on October 28, 2013, at 22:54:51
In reply to Re: Anxiety Treatment Needed » Hugh, posted by Fiat500 on October 26, 2013, at 23:23:23
Thanks for all your input guys
Posted by babbler20 on October 30, 2013, at 21:50:57
In reply to Re: Anxiety Treatment Needed, posted by b2chica on October 22, 2013, at 13:55:48
> i have tried many things for anxiety and the best things i've tried is xanax (but can only use temp-usually only about a week or two before it messes with my cognition)
> gabapentin
> and Perphenazine. about 2-4mg/BID very low dose worked Fantastic for my tough anxiety.
>
> b2cHi, thanks for posting. Did you have any side effects from Perphenazine? Can it be used as a long-term treatment? I'm glad you found help with your anxiety. I've had the worst anxiety for the past year and I'm ready to get rid of it already.
Posted by b2chica on October 31, 2013, at 10:01:46
In reply to Re: Anxiety Treatment Needed, posted by babbler20 on October 30, 2013, at 21:50:57
no None Perphenazine was great for me.
at first i took 2mg am, then 2mg evening. i cant even remember if i had any startup SE. maybe some somnolence? but dont even think i had that. i stayed on that regimen for about year and half.
i think at one time i was down to just the am dose, and it was working well. as my anxiety tends to peak about 11-11:30ish.then towards the end i went from 2m BID to 2mg am and 4mg pm and i think in about a week i became more depressed however i was more depressed.. so not sure if it was increase in med or not. i ended up adding zyprexa to the mix (again) and became better. no issues either with mixing zyprexa and perphenazine, although when i upped to 10mg zprexa i did stop the perphenazine as the zyprexa killed the anxiety dead.
ive since gone off perphenazine. however, i would never hesitate to go back on it.
it worked very well for me.best wishes.
Posted by former poster on October 31, 2013, at 14:33:47
In reply to Re: Anxiety Treatment Needed » Babbler20, posted by Phillipa on October 19, 2013, at 23:04:20
I agree with Phillipa. I've been on and off benzo's for 30 years. Same dose seems to give almost the same effect. About a year ago I was in a great state of mind and forgot to take my clonazepam for a couple days, I felt fine, until I realized I forgot to take them. The thought of not having them made me almost panic. Psychological addiction is maybe just as strong as physical addiction.
If you truly have anxiety that doesn't respond to other treatments, benzo's are astonishing, life changing.
One thing I noticed: Seems benzos can make you "put off" fixing the thing that causes anxiety. Try to stop the benzo, the anxiety causing situation is still there and maybe even more situations have arisen, you have no psychological coping mechanism.
Clonazepam works so well.. I would have had a horrible life without it and probably become psychotic. I recommend staying away from Valium, Xanax.
Posted by Phillipa on October 31, 2013, at 18:45:59
In reply to Re: Anxiety Treatment Needed » Phillipa, posted by former poster on October 31, 2013, at 14:33:47
The ones I take at night only. Glad the K works well for you. Phillipa
Posted by former poster on November 4, 2013, at 0:12:05
In reply to Anxiety Treatment Needed, posted by Babbler20 on October 19, 2013, at 22:49:59
Sorry I forgot to mention NAC (N-acetyl-L-cysteine) for anxiety. It works amazingly well, but not immediately as benzo's do. I use Bluebonnet 500mg brand. I haven't had much luck with other brands. Capsules should have an odor of sulfur.
I haven't heard of *N-acetyl-glucosamine*. Is that a type-o?
Hope you feel better.
Posted by former poster on November 4, 2013, at 0:37:02
In reply to Re: Anxiety Treatment Needed » Phillipa, posted by former poster on October 31, 2013, at 14:33:47
"I recommend staying away from Valium, Xanax."
This is just in my opinion. Valium "feels" more addictive, has many long lingering active metabolites, making it easier to overdose. Xanax also "feels" addictive, is too short acting and more likely to cause withdrawal anxiety.
Posted by Hugh on November 11, 2013, at 11:18:15
In reply to Re: Anxiety Treatment Needed » Hugh, posted by Fiat500 on October 26, 2013, at 23:23:23
> I can't find any studies or info as to how n-acetyl glucosamine works for anxiety. Do you have any links? I wonder if it would have any drug interactions.
The only reports I've seen have been anecdotal, and there haven't been many of those. But NAG is a fairly new supplement.
This is the end of the thread.
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