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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by BusuB on October 7, 2014, at 10:36:04
Good morning Babblers, so I've been on a pretty rocky medication quest to help with my GAD and resultant depression (Dr. thinks I get depressed due to my anxiety rather than a problem on its own).
At any rate, I've been through multiple medication trials to include most of the SSRI class (Luvox is the only one I hadn't tried), Clomipramine, and the SNRI's Cymbalta and Effexor. Along the way, I've augmented with buspirone and lamictal in addition to getting a lot of sleep relief from Trazodone.
The problem? All of the AD's cause a lot of inner restlessness that doesn't go away. What I mean by that is that it's kind of like anxiety, but in a way I can tell that it's not MY anxiety... if you know what I mean. My anxiety is a pit of the stomach dreadful feeling, and the medication seems to produce a jittery caffeinated (and very uncomfortable) feeling. Not to mention the insomnia (no problems falling asleep but I find myself awake at 4am every morning with the aforementioned jitters).
Unfortunately, benzos give me a hung over, dysphoric feeling the day after use, but I will use an ativan if the caffeinated feelings gets too strong. Obviously not a long term solution.
I'm currently on 20 mg citalopram for the past 4 weeks after titrating up from 10 mg (which I had been on for 3 weeks). Total of 7 weeks and I still have that agitated jittery feeling daily, and my sleep still sucks. Mood is.... okay. I can definitely improve in that arena, but I think proper sleep and getting rid of the jitters will go a long way in alleviating that.
At any rate, at my last appointment, my pdoc mentioned the possibility of using Trileptal (didn't specify as add-on or mono therapy) to help with the GAD. Has anyone else heard of this? Any experience with Trileptal in general (as in is it calming)? I see him in a couple of days for a follow up, so any insight would be helpful.
Posted by Sheilac on October 7, 2014, at 17:58:54
In reply to Trileptal for Anxiety?, posted by BusuB on October 7, 2014, at 10:36:04
I use Klonopin for anxiety, but in the past I have used Trileptal as a mood stabilizer and have found it calming, so much that I didn't need as much Klonopin.
I say give it a try. Even a low dose might work.
Posted by BusuB on October 8, 2014, at 12:17:39
In reply to Re: Trileptal for Anxiety?, posted by Sheilac on October 7, 2014, at 17:58:54
> I use Klonopin for anxiety, but in the past I have used Trileptal as a mood stabilizer and have found it calming, so much that I didn't need as much Klonopin.
>
> I say give it a try. Even a low dose might work.Thanks for you input Sheila. One more question, did you find that it affected your mood in any way? Good or bad? I ask because I've been feeling quite "dull" so to speak on the citalopram. I'm hoping this is a short term effect though.
Posted by LouisianaSportsman on October 11, 2014, at 22:00:07
In reply to Trileptal for Anxiety?, posted by BusuB on October 7, 2014, at 10:36:04
I highly suggest Aptiom (eslicarbazepine acetate tablets) for a once daily dosage of the least enzyme-inducing version. It is the active metabolite of Trileptal (oxcarbazepine).
I also advise looking into the Equetro formulation since it is FDA indicated for bipolar disorder.
Posted by Sheilac on October 15, 2014, at 13:29:19
In reply to Re: Trileptal for Anxiety? » Sheilac, posted by BusuB on October 8, 2014, at 12:17:39
Yes, Trileptal can make you feel a little dull or flat. At least it has me at higher doses.
Posted by phidippus on October 20, 2014, at 19:54:55
In reply to Trileptal for Anxiety?, posted by BusuB on October 7, 2014, at 10:36:04
>All of the AD's cause a lot of inner restlessness that doesn't go away.
This is called akathisia. You can stop the drug causing it or you can take something like propanalol, cogentine, amantadine or artane to treat it. Benzos don't do a very good job of treating akathisia.
I found Trileptal worsened my anxiety, as most sodium channel blockers do. Anticonvulsants that do help anxiety include Neurontin, Tiagabine, Keppra, Lyrica and Depakote to some extent.
Eric
This is the end of the thread.
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