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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by jay on June 8, 2002, at 5:38:08
Just curious:
I respond to benzos VERY, VERY well. More than any med, for almost 8 years, they still respond by almost 'erasing' anxiety and depression right away, and damn it feels so good.
Say in conjunction with an a.d., what is the best one for a positive benzo responder? I have had terrible experiences with the 'newer' a.d's, and wonder if the older tricyclics are the best for this. I have a hunch imipramine may be it..haven't tried it yet though.
I have some very, very strong fears (maybe some are irrational) about my physical state of health...very, very high anxiety. All of the newer meds seem to pump that anxiety beyond belief.
Any comments welcomed...thank you
Jay
Posted by katekite on June 8, 2002, at 11:57:21
In reply to MAJOR Benzo responder...what best A.D's?, posted by jay on June 8, 2002, at 5:38:08
I liked benzos but not the dependence or sedation.
You might try neurontin.. not really an AD but a small proportion of people find it works great as an AD. ie for those for whom it works, it works wonders. It is mainly anti-anxiety. The great thing about it is that you can start at an effective dose and you will know in a couple days if it will work.... whereas all the ADs you have to wait weeks and weeks with little anxiety help. So you make another appointment with the doctor for the following week in case it doesn't do the trick. I had a great response to neurontin, initial side effects were a little weird and lasted one day, then I felt calm and younger and able to enjoy myself. Very few side effects. Couldn't recall why I had been so scared of social situations since it was now so nice to talk to people. LOL.
What ADs have you tried and what were your complaints about them? Past experiences often are helpful in knowing what class of drugs to turn to next.
Regarding health worries, the newer ADs have these wonderful little nagging bizarre side effects that could drive anyone into that. Hmmm, why is my left ear buzzing? stuff like that.
kate
Posted by Ritch on June 8, 2002, at 16:01:17
In reply to MAJOR Benzo responder...what best A.D's?, posted by jay on June 8, 2002, at 5:38:08
> Just curious:
>
> I respond to benzos VERY, VERY well. More than any med, for almost 8 years, they still respond by almost 'erasing' anxiety and depression right away, and damn it feels so good.
>
> Say in conjunction with an a.d., what is the best one for a positive benzo responder? I have had terrible experiences with the 'newer' a.d's, and wonder if the older tricyclics are the best for this. I have a hunch imipramine may be it..haven't tried it yet though.
>
> I have some very, very strong fears (maybe some are irrational) about my physical state of health...very, very high anxiety. All of the newer meds seem to pump that anxiety beyond belief.
>
> Any comments welcomed...thank you
>
> Jay
Jay,Which tricyclic? I guess that depends on just how zombified you want to be. :) Doxepin is the most sedative one, followed by amitriptyline. They used to make Limbitrol-which was a combination of amitriptyline and chlordiazepoxide (Librium). I don't know if they still make it or not. Probably trimipramine would be perhaps a little less sedative than amitrip.(though I haven't tried that one). Nortriptyline is very mildly sedative. Imipramine is mildly sedative, too. I am taking that one now, but not much of it. Desipramine and protriptyline are fairly activating.
Mitch
Posted by JohnX2 on June 8, 2002, at 19:37:08
In reply to MAJOR Benzo responder...what best A.D's?, posted by jay on June 8, 2002, at 5:38:08
> Just curious:
>
> I respond to benzos VERY, VERY well. More than any med, for almost 8 years, they still respond by almost 'erasing' anxiety and depression right away, and damn it feels so good.
>
> Say in conjunction with an a.d., what is the best one for a positive benzo responder? I have had terrible experiences with the 'newer' a.d's, and wonder if the older tricyclics are the best for this. I have a hunch imipramine may be it..haven't tried it yet though.
>
> I have some very, very strong fears (maybe some are irrational) about my physical state of health...very, very high anxiety. All of the newer meds seem to pump that anxiety beyond belief.
>
> Any comments welcomed...thank you
>
> JayI'm personally interested in this novel AED Keppra.
Dr. Goldberg was talking about some positive experience
for treatment resistant bipolar.There were some abstracts showing in animal models
that it negated the crummy effects of a BZD antagonist (a medicine
that blocks the benzo site).But its pretty new...
John
Posted by judy1 on June 8, 2002, at 21:09:58
In reply to MAJOR Benzo responder...what best A.D's?, posted by jay on June 8, 2002, at 5:38:08
If benzos are so helpful for your anxiety/depression why in the world do you want to change to an AD? My pdoc has had many patients on benzos for 10, 20 years and they are still doing well with none of those nasty side-effects that some ADs have. If you're worried about dependence, AD's have some of the worst withdrawals. Best of luck- Judy
Posted by jay on June 9, 2002, at 0:53:24
In reply to Don't understand » jay, posted by judy1 on June 8, 2002, at 21:09:58
> If benzos are so helpful for your anxiety/depression why in the world do you want to change to an AD? My pdoc has had many patients on benzos for 10, 20 years and they are still doing well with none of those nasty side-effects that some ADs have. If you're worried about dependence, AD's have some of the worst withdrawals. Best of luck- Judy
Hi Judy:
Thanks for the post. What I do still have, though, is 'break-through' periods of depression. They can hit pretty hard, and yes they can cause a major impairment, and lead to very nasty feelings.
But I do know what you are saying about benzos, as I have no problem taking them forever. I thought maybe one of the older tricyclics would compliment my benzo use, but right now I am so afraid of antidepressants, it's going to take awhile to ease onto one. I refuse to ever try an SSRI again, as at various points, they made me suicidal. (I know they may be helpful for some, but many studies have shown they can also cause alot of problems. If they helped me, sure, otherwise I am not going to risk my life.) 6 years ago I took my first dose of Prozac, and I remember that day well, because it was a beautiful summer day, I was in a fair mood, and overnight turned into a tormented soul who hated everything and wanted to end his life.
Also, I am very unsure of all of these claims that if you respond 'negatively' to an a.d., you are bipolar. That seems far too simple of a blanket statement.
Soo..sorry for going on, but it's just all inter-connected. I've got my stash of benzos for now, and see the doc in a week, and will look at things from there. Maybe your and my advice is good, that folks who have been through hell on a.d.'s may want to try the mono-benzo route for a good period of time, then re-evaluate their situation.
Thanks..:-)
Jay
Posted by jay on June 9, 2002, at 1:02:03
In reply to Re: MAJOR Benzo responder...what best A.D's? » jay, posted by JohnX2 on June 8, 2002, at 19:37:08
>
> I'm personally interested in this novel AED Keppra.
> Dr. Goldberg was talking about some positive experience
> for treatment resistant bipolar.
>
> There were some abstracts showing in animal models
> that it negated the crummy effects of a BZD antagonist (a medicine
> that blocks the benzo site).
>
> But its pretty new...
>
> JohnHmm..interested...but if this turns out to be another 'Neurontin'..well..ughh. (Anti-Neurontin rant..:-)..That med acts *nothing* like benzos, from my experience, and I really see little evidence for it in treating anxiety, GAD, PAD, etc. As for it as an 'anti-depressant'...bahhh..what a stretch!
I do have one interesting experience with Buspar. I was thinking of maybe taking it again. I took a good dose of Buspar (I think I took 15-20 mg's 2x a day), and a good benzo dose, and man I got a very excellent response. Maybe it's all the mucking around with a mix of dopamine, serotonin agonism/antagonism and the benzos.
If this works...I will post indeed!
Thanks...
Jay
Posted by jay on June 9, 2002, at 1:13:02
In reply to Re: MAJOR Benzo responder...what best A.D's? » jay, posted by Ritch on June 8, 2002, at 16:01:17
> > Just curious:
> >
> > I respond to benzos VERY, VERY well. More than any med, for almost 8 years, they still respond by almost 'erasing' anxiety and depression right away, and damn it feels so good.
> >
> > Say in conjunction with an a.d., what is the best one for a positive benzo responder? I have had terrible experiences with the 'newer' a.d's, and wonder if the older tricyclics are the best for this. I have a hunch imipramine may be it..haven't tried it yet though.
> >
> > I have some very, very strong fears (maybe some are irrational) about my physical state of health...very, very high anxiety. All of the newer meds seem to pump that anxiety beyond belief.
> >
> > Any comments welcomed...thank you
> >
> > Jay
>
>
> Jay,
>
> Which tricyclic? I guess that depends on just how zombified you want to be. :) Doxepin is the most sedative one, followed by amitriptyline. They used to make Limbitrol-which was a combination of amitriptyline and chlordiazepoxide (Librium). I don't know if they still make it or not. Probably trimipramine would be perhaps a little less sedative than amitrip.(though I haven't tried that one). Nortriptyline is very mildly sedative. Imipramine is mildly sedative, too. I am taking that one now, but not much of it. Desipramine and protriptyline are fairly activating.
>
> MitchYes I have had some experience with many tricyclics, minus the imipramine and trimipramine.
Doxepin was like being hit by a truck...Nortriptyline had sometimes *excellent* responses, but othertimes kinda nasty. Protriptyline, well, I am not sure if it is available in Canada anymore. (The drug database say 'Triptil' was discontinued..the brand name..not sure if it is available still in generic). Amitriptyline was ok for a few weeks..then it turned me suicidal and just horrible.So, if Protriptyline isn't available, I will try imipramine. Maybe a combo of imipramine and nortriptyline..I dunno.
Anyhow...thanks for the comments!
Jay
Posted by JohnX2 on June 9, 2002, at 1:18:44
In reply to Re: MAJOR Benzo responder...what best A.D's? » JohnX2, posted by jay on June 9, 2002, at 1:02:03
> >
> > I'm personally interested in this novel AED Keppra.
> > Dr. Goldberg was talking about some positive experience
> > for treatment resistant bipolar.
> >
> > There were some abstracts showing in animal models
> > that it negated the crummy effects of a BZD antagonist (a medicine
> > that blocks the benzo site).
> >
> > But its pretty new...
> >
> > John
>
> Hmm..interested...but if this turns out to be another 'Neurontin'..well..ughh. (Anti-Neurontin rant..:-)..That med acts *nothing* like benzos, from my experience, and I really see little evidence for it in treating anxiety, GAD, PAD, etc. As for it as an 'anti-depressant'...bahhh..what a stretch!
>
> I do have one interesting experience with Buspar. I was thinking of maybe taking it again. I took a good dose of Buspar (I think I took 15-20 mg's 2x a day), and a good benzo dose, and man I got a very excellent response. Maybe it's all the mucking around with a mix of dopamine, serotonin agonism/antagonism and the benzos.
>
> If this works...I will post indeed!
>
> Thanks...
> JayYeah, I thought the Keppra looked interesting because I
grew tolerant to Klonopin which has been my best stabilizer to
date. Neurontin was a bit of an anxiolitic, but nothing like
the benzos as you mentioned.In those animal studies of Keppra, they were able to give the
animals anxiogenic medicines that blocked the Gaba benzo receptors and
this did not induce seizure activity. I don't know if there is
any other AED that can claim to do that. But this is in animals
and its early in the game so who knows (need some real world data).It's interesting you did well with Buspar. Some people believe
that hyperactive sertonergic action is the culprit behind anxiety.
Both buspar and the benzos (GabaA agonists) reduce the firing rate
of hyperactive serotonin neurons.John
Posted by omega man on June 9, 2002, at 2:31:57
In reply to MAJOR Benzo responder...what best A.D's?, posted by jay on June 8, 2002, at 5:38:08
being pre-disposed to anxiety means benzos basically....AD's make me anxious too..although I have wide enough experience to use AD's for many other reasons which help my life and have a knock on effect in reducing anxiety long term..
I had to learn the hard way I was hooked on benzos for eight years....Uk Pdocs decided to stop me and the withdrawal made me ill for three...I still need them now..but I realized that much of my anxiety was irrational thinking and a misunderstanding of me in my relation to life...but how to explain that ??
I spent my three years withdrawing doing intense study on the nature of the brain, and the theosphy of practically every major life subject you'll see in a university library...
I had to learn to use my mind properly..and while I realize my amygdala may be the size of walnut..and needs some help I also realize that adjusting my life and hobbies and relationships and what I do for a living...eating exercise etc has more profound effects on stopping it swelling up.....especially how I react to events...
benzos would be just great without the addiction cycle....
but why are they addictive ?
the brain produces GABA anyway...not enough in our case perhaps...perhaps its the lovely floaty effects on the body that induce addiction..
Chemically at the moment there are few options..although omega 3 helps my anxiety by creating the space for me to remember my anti-anxiety CBT training ....sometimes life will throw too much at me and beat me into a jumpy wreck...but its better to wait for that to happenas benzos cannot be used safely all the time...so thats when I reach for trazepam....(I would recommend that as it does not induce pleasure craving like Xanax)..in fact the grogginess of trazepam...makes it only usefull for when anxiety is driving you beyond other relief..
until we get something that helps anxiety safely..and let you live life like how you want...it means living to how you need to..
I found I use lots of non-drug strategies to keep the need to take benzos right down to perhaps two to three times a week...many times I don't need them for months..like summer...but mostly being involved in activities with other anxiety sufferers helps us to get thru it all by relying on each other rather than the drugs..
Posted by Alan on June 9, 2002, at 21:46:08
In reply to Re: MAJOR Benzo responder...what best A.D's? » JohnX2, posted by jay on June 9, 2002, at 1:02:03
> >
> > I'm personally interested in this novel AED Keppra.
> > Dr. Goldberg was talking about some positive experience
> > for treatment resistant bipolar.
> >
> > There were some abstracts showing in animal models
> > that it negated the crummy effects of a BZD antagonist (a medicine
> > that blocks the benzo site).
> >
> > But its pretty new...
> >
> > John
>
> Hmm..interested...but if this turns out to be another 'Neurontin'..well..ughh. (Anti-Neurontin rant..:-)..That med acts *nothing* like benzos, from my experience, and I really see little evidence for it in treating anxiety, GAD, PAD, etc. As for it as an 'anti-depressant'...bahhh..what a stretch!
>
> I do have one interesting experience with Buspar. I was thinking of maybe taking it again. I took a good dose of Buspar (I think I took 15-20 mg's 2x a day), and a good benzo dose, and man I got a very excellent response. Maybe it's all the mucking around with a mix of dopamine, serotonin agonism/antagonism and the benzos.
>
> If this works...I will post indeed!
>
> Thanks...
> Jay==========================================
You may want to check prescribing info with your pharmacist. I believe that BZD's and Buspar should NOT be taken simultaneously. As a matter of fact, I understood it was best to let 6 weeks pass between the two - Buspar never working as well again after having taken BZD's.Alan
Posted by pharmer on June 9, 2002, at 23:25:35
In reply to MAJOR Benzo responder...what best A.D's?, posted by jay on June 8, 2002, at 5:38:08
You might consider clomipramine.Ifound it worked well for my anxiety along with clonazepam.Great combo.for ocd,depression and anxiety. Rick
Posted by jay on June 12, 2002, at 4:05:54
In reply to Re: MAJOR Benzo responder...what best A.D's? » jay, posted by Alan on June 9, 2002, at 21:46:08
> You may want to check prescribing info with your pharmacist. I believe that BZD's and Buspar should NOT be taken simultaneously. As a matter of fact, I understood it was best to let 6 weeks pass between the two - Buspar never working as well again after having taken BZD's.
>
> AlanI can see why a beno responder, if switched completely to Buspar, will not get the same effect. In fact, there is very little in similar effect between the drugs.(Buspar having *nothing* to do with benzo receptors/gaba) That's how my pdoc explained it.
If you are on benzo monotherapy...it may be the best alternative to SSRI's and the like. (In combination).
Jay
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